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TO THE LEGISLATURE. 


A PLEA 


FOR THE 


INSANE 


IN THE 


PRISONS AND POOR-HOUSES 


/ " 


PENNSYLVANIA. 


PHILADELPHIA : 


A. C. Bryson & Co., Steam-Power Printers, 607 Chestnut Street. 


1873. 



CONTENTS: 

Pag*. 

Insane Poor 1-27 

riminal Insane, &c, ! 27-103 



INDEX 



Art of 1861, evil eflfects of, 46, 47, 50, 56; 
remands Insane from Hospitals to Prisons, 
40; Judge Brewster's Opinion of, 61-64; 
rt_-pc.il demanded, 39. 

Aims-Houses, Sufferings of Tnsane in, 7, 15. 

Appeals, from Inspectors of Penitentiaries, in 
1844, i s 57. 1871,34. 37. 

ition of "Criminal Insane" with felons, 
88, 91. 

Claims of Insane upon the State, 13. 

Chronic Neglect of Insane in Poorhouses, 16 ; 
causes of, 19. 

Cruel detention of Insane in Jails, 33-37. 

Cure of Insane, 29; percentage, 12. 

Convict Insane, 27 ; condition, needs, 33-37 ; 
separate department for, in State Hospitals 
suggested, ^, 59, 101. 

Criminal Insane, 5 ; before trial, 27 ; untried, 
28 ; should not be in jails, 29 ; condition 
in State Penitentiaries, 32-37, 56; remedies 
proposed, 96. 

Duty of State to all Insane Poor, 100 ; to In- 
sane Criminals, 31. 

Dangerous Lunatics, proper provision for, 101. 

Danville, Insane Hospital, special department 
for Criminal Insane suggested, 73, 75,96. 

Eastern Penitentiary, Insane Convicts in, 32, 
74 ; recommendation of Inspectors, 55 ; 
Warden's Reports, 32-34. 

Frightful Condition of Insane in Poorhouses, 
10, 14, 16, 17 ; in Prisons, 8, 10. 

Facts, about present cruel neglect of Insane 
Poor, 15-19; about Criminal in Peniten- 
tiary, 33-37. 

Harmless Insane, 5 ; care of, 25, 38 ; cruel 
indefinite imprisonment of, 46. 

Harmful Insane, 5, 25; not always criminals,38. 

Humane Legislation in other States, 64. 

Humane treatment of Insane Criminals, 93 ; 
nullified by Act of 1861. 

Hardships of Poor Insane Criminals, 31 ; 
remedies proposed, 48. 

Hopeless Condition of Insane-inPoorhouses,53 

Insanity, a cause of pauperism, 13. 

Insane, simply put out of sight, 20; duty of. 
state to, 4. 

Inhuman View of Insanity of Criminals, 93. 

Insane Poor, What the State ought to do, 5, 

7, 27, 54, 101 ; unjust treatment of, 23 ; 

number now suffering, 100; not removed to 

ral hospitals, 21 ; memorial of judges 

- ipreine Court, 51 ; memorials in behalf 

of, 94 96. 

Insane Convicts, before and after conviction, 
5. 27, transfer to Asylums, 29; separate 
department for, needed, 60, 73, 75, 76; 
should be in hospitals, 85, 86, IOO ; Discus- 
sion mod of Medical Superinten- 
dents at Baltimore, 74-85, Memorials, 94-96. 



Insane Criminals, injudicious treatment of, 8; 
in Penitentiaries, 32, 57, 59; suggestions, 
79, 80 83, 90, 97 ; concurrent testimony 
respecting, 80 — S^- 

Incurable Insanity, caused by present neglect 
in Poorhouses, 53 ; by punishment as con- 
victs, 30; discharges from State Hospital, 
23 ; remarks, 102. 

Insane Hospitals, State, not largely used for 
Poor Insane, 21. 

Jails not proper places for the Insane, 55, 85, 
89, 100. 

Legislation, course of, in Penn'a, 39—46; 61 
64, proposed 98, 102. 

Moral Insanity, viciousness of, 4. 

Medical Superintendents of Insane Hospitals, 
Discussion by Associations of, 74-85. 

Numbers of Insane Poor now raving and ne- 
glected in Poorhouses, 53. 

No Insane Person should be in Prison, 101. 

Oi.ginal intention of Penna. Legislature frus- 
trated, 22, 46. 

Practising Physicians, Memorial in behalf of 
Insane, - . 

Pauperism caused by Insanity, 13. 

Perversion of State Hospitals to use of "rich" 
patients, 22-23. 

Parsimony of Directors of the Poor, 19 ; In- 
sane not sent to Asylums, 53. 

Partisanship in appointments, Evils of, II. 

Reforms, progress of, 14, 21. 

Remedies proposed for present evils, 20, 91, 
99, 100-102. 

State, duty of the, to Insane, 13. 

Stewards and Superintendents, Incompetency 
of, 11, 19. 

Special Hospital Department for Insane Con- 
victs, 79, 86, 88. 

Supervision of Insane Hospitals, the proper, 26. 

State Lunatic Asylum, original object of 56 ; 
provisions of, 100; "pay" patients ad- 
mitted, 21 ; "poor" shut out, 21-25, 5°> IO °- 

Superintendents of Hospitals for the Insane, 
Letter of President of Board, 75-79. 

Temporary Insanity, crimes during, 27, 30, 38. 

Testimony, High character of, in this "Plea," 
102. 

Use of Prisons for Detention of Insane, evils 
of, 20. 

Warden Townsend, report, 74 ; Warden 
Wright, Insane in Western Penitentiary, 

34-37, 74- 
What the State ought to do for the Insane, 
11, 27, 29, 32; provide for all Insane Poor, 
22, 54; Repeal the Act of 1861, 39; gen- 
eral suggestions, 99-103. 



TO THE LEGISLATURE. 



A PLEA 



INSANE 



IN THE 



PRISONS AND POOR-HOUSES 

OF 

PENNSYLVANIA. 

4y 



PHILADELPHIA ■ 

A. C. Bryson & Co., Steam-Power Printers, 607 Chestnut Street. 

1.873. 



^ 



BOARD OF PUBLIC CHARITIES 



OF 



- PENNSYLVANIA, 



OFFICERS. 

President : 

GEORGE L. HARRISON, 
Philadelphia. 

General Agent and Secretary : 

DILLER LUTHER, M.D., 
Reading. 

Members of the Board : 

GEO. L. HARRISON. WM. BAKEWELL. 

G. DAWSON COLEMAN. A. C. NOYES. 

HIESTER CLYMER. GEORGE BULLOCK. 

FRANCIS WELLS. 

Statistician : 
A. J. OURT. 



THE INSANE. 



Insanity, in its relation to legislation and jurisprudence, 
as well as to mental, moral and medical science, to its char- 
acteristics and the mode of determining its presence, as well 
as the method of treatment for its cure, to the best means of 
protecting society against its violent or mischievous assaults, 
as well as to its claims upon our human regard and sympa- 
thy ; — is a subject of great difficulty, but, at the same time, 
of commensurate interest and importance. 

It is not easy to give a clear 

DEFINITION OF INSANITY, 

and when we attempt it, the danger is that we run into one 
extreme or another, and either allow none to be insane but 
the raving maniac, or make all insane who commit anything 
foolish or wrong. But we need not attempt a definition 
here. 

Whenever the condition of the raving maniac is so far 
approximated, and the reason sofar disordered or dethroned, 
that the apprehension of the distinction between right and 
wrong is lost, either wholly and in all relations, or partially 
and in relation to some particular subjects, then insanity so 
far exists as to demand to be specifically recognized in the 
administration of justice, in the means to be provided for 
the protection of society, and in determining the treatment 
due to those who are its subjects. 

The diagnosis of such cases we may leave to experts, and 
the determination of the facts to the proper officials, j udges 
or juries. We have nothing here to do with the question of 
insanity as it is presented to the psychologist or to a petit 



jury or to a commission de hinatico inquirendo, or to a board 
of medical examiners. In the cases to which we propose to 
call attention, we assume the fact of insanity to be estab- 
lished, and then, looking at the insane man afterwards, 

WE INQUIRE WHAT IS TO BE DONE ? 

But we must protest, at the outset, against a certain form 
of mistaken feeling, which, we suspect, may very generally 
exist : — we refer to the disposition to regard all persons, 
who, being charged with crime, are acquitted on the ground 
of insanity, as at least highly suspicious characters, to be 
classed with criminals without reserve, because it happens 
that the greatest criminals so often seek to evade the punish- 
ment due to their crimes by setting up 

THE PLEA OF INSANITY. 

But this sweeping generalization is no more reasonable — 
especially in the case of the poor, who have no powerful 
friends to work for them, and cannot pay liberal fees for an 
elaborate defence, than it would be to regard all men as 
criminals and suspicious characters, who are charged with 
any crime, however clearly their innocence may be demon- 
strated ; for this plea of insanity is, by no means, the only 
plea which is abused for the protection of knavery and 
violence. 

As to the specious modern plea of 



either it must be absolutely rejected, or all administration of 
penal jurisprudence must, consistently, be abandoned. Any 
insanity, that can be recognized in law, must include a de- 
rangement or loss of the rational faculties, and by such de- 
rangement or loss it must be measured. A " moral insanity' 7 
which consists merely in an abnormal violence of vicious 
propensities, or of some particular vicious propensity, while 
yet the light of reason remains unabridged, and the conscious 
moral judgment is clear and distinct, is only another ex- 



pression either for diabolical wickedness, or for the ordinary 
condition of human temptation. 

But, waiving all such discussions, the subject which we 
desire to present to the practical consideration of the Legis- 
lature is this : 

WHAT PUBLIC PROVISION" SHOULD BE MADE FOR THE CARE 



including thpse who have been convicted of crime or 
charged with its commission. 

In order to a clear exposition and apprehension of the 
subject which we thus desire to present, it will be advisable 
and even necessary to analyze it, and to distribute the insane 
into their several classes, with reference to the end we have 
in view ; — to the public provision to be made for their safe- 
keeping, care and treatment. With this view, the insane 
may be distributed into 

THREE DIFFERENT CLASSES. 

1. Those who have done no violence or public harm — the 
ordinary insane. These, again, fall into two sub-classes : 

1. The harmless, or those from whom no harm is feared. 

2. The harmful — those with manifestly dangerous and de- 
structive propensities. 

2. Those who have done harm — have committed crime — 
while sane, but (1) have become insane before trial or con- 
viction ; or (2) have become insane after conviction ; — " in- 
sane convicts" in the strict legal sense. 

3. Those who having done harm, having committed acts 
of violence or mischief, have been acquitted of crime on the 
ground of insanity. 

And first, of the 

INSANE WHO HAVE; DONE NO HARM. 

Among these, the insanity may vary in character and degree 
from some simple special hallucination down to complete de- 
mentia. It may include both sexes and all ages ; may pro • 



6 



ceed from a variety of causes, moral and physical, may be 
recent or may have become chronic, may be more or less 
violent or dangerous, may be curable in various degrees, or 
may be absolutely incurable. These varieties may call for 
various medical classifications and modifications of treat- 
ment ; all which we leave to medical men to arrange and 
determine. The classification which more directly concerns 
us, viewing the subject in its relation to the demand for leg- 
islative interposition or State aid, is 

1. Those who have the means of support, and - * 

2. Those who are dependent and destitute. 

The first class can be cared for, either at home by their 
friends, or at private asylums established for the purpose. 
The only occasion for legislative interposition in their behalf 
is, to see that they have proper guardianship to secure them 
in the possession and right use of their property. And the 
only occasion for such interposition for the protection of the 
community in this regard, is, on the one hand, to see that 
friends, who undertake their guardianship, do not neglect it 
to the peril of the community, or abuse it to the detriment of 
the sufferer ; and, on the other hand, to provide lest by the 
criminal collusion or interested misjudgment of relations and 
physicians, any sane person should, under certain circum- 
stances of helplessness or exposure, be condemned to the 
living death of incarceration, in some private hospital for 
the insane : — a fate next in horror to that of being buried 
alive. As to what legislation is required in relation to this 
class, we have only to refer to the suggestions presented in 
our last report. 

But however important the claims of this class may be 
upon the public consideration, they are as nothing in com- 
parison with those of the other class of the harmless insane r 
viz : 

THE DESTITUTE*' AND DEPENDENT. 

To these and their sad fate, we beg once more respectfully 
but most earnestly, to urge the serious and special atten- 



tion of the Legislature. In our former reports, we have not 
overlooked the claims of these helpless victims of the 
sorest of human maladies ; but, in the discharge of our offi- 
cial duty, we have, repeatedly, though hitherto, perhaps, 
without sufficient fullness and emphasis, presented those 
claims to the consideration of the Legislature, and we now 
beg to refer to our 

FORMER STATEMENTS AND SUGGESTIONS ON THIS SUBJECT. 

In our report for 1870 : " More especially do we wish to de- 
nounce the cruel wrongs which the insane suffer who are in- 
mates of almshouses. These institutions are generally 
wholly unsuitable for their care or even detention! or, if 
suitable, are presided over by persons who are entirely igno- 
rant of the needs of this class of the sick and infirm, and 
whose administration is based on the crudest ideas of 
mental disease; it is limited to the discovery of the most 
available methods of preventing them from harming any- 
thing or any person but themselves. We could instance the 
most glaring abuses, not, as we believe, intentionally inflict- 
ed, but the result of incapacity and ignorance. The time 
has gone by when a disturbed imagination or a disordered 
intellect should be held to have converted its human victim 
into a distempered brute, whose home should be akin to the 
sty or the stable, and whose lightest restraint should be perpet- 
ual incarceration within the limits of a cell. These wrongs de- 
mand prompt redress. No hospital for the insane should remain 
without the constant supervision of a medical superintend- 
ent. The stewards of almshouses are never selected from 
any consideration of the needs of the insane." 

The report was also accompanied with the following for- 
mal resolutions of the Board. 

Resolved, " That the Board of Public Charities, having 
witnessed the evils which result from the connection of in- 
sane asylums with almshouses, and believing that a wrong is 
done to the insane by classing them with paupers, hindering 
the public from estimating aright their claims to sympathy 



8 

and remedial treatment, disapprove of such an alliance, and 
believe that the best interests of this afflicted class of the 
people, and the duty of the State, concur in the establish- 
ment by the State, within a reasonable time, of sufficient ac- 
commodations for the maintenance and treatment of all the 
insane who may not be cared for in private hospitals." 

Resolved, "That, in the judgment of the Board, all superin- 
tendents of hospitals for the insane should be members of the 
medical profession." 

In 1871, the following, from our General Agent, was laid 
before the Legislature : — 

"In «ome of our prisons, cases of insanity are found 
which ought to be transferred to hospitals established for the 
maintenance and treatment of this class of persons. In the 
course of my inspection of these institutions, as will be seen 
by a reference to my report, instances of this character have 
been noticed. It occasionally happens that insane persons 
have to be, at least temporarily, committed to a prison ; but 
few cases can arise where this necessity exists for any great 
length of time. If they have been arrested for a crime, the 
law has made ample provision for a proper disposition of 
them, without a protracted confinement in a county jail, and 
the sooner they are removed therefrom the better, whether 
their incarceration is the result of crime or merely for the 
purpose of safe-keeping. All the better feelings of humanity, 
as well as a sound philanthrophy, concur in this sentiment. 
<^" Among the various defects in our poorhouses, none are 
more to be deplored than that which relates to the provision 
made for the insane. Scarcely one can be mentioned which 
is not deficient in this particular. The sexes, like the ar- 
rangements in the other departments, are frequently allowed 
to mingle together; few have suitable accommodations for 
their comfort, and even in the best of them, there is a lack 
of sufficient attendance. New buildings have been erected 
in several counties, with a view to increased facilities for the 
support of this class, but even here, in some cases, persons 
have been selected who have no experience and but little 



qualification for the duties to which they have been as- 
signed. 

" The attention which I have given to this grave subject 
induces me to believe that all case3 of an acute character 
should be placed in one of the public institutions which have 
been established in the State, City, or County, with a view to 
their treatment. To place a recent case where no suitable 
medical treatment or other proper attendance can be had, is 
either simply to leave it to nature or facilitate its passage 
into a chronic condition. To render an institution suitable 
for the successful management of such cases, nearly all the 
means essential for such a purpose are wanting. A proper 
construction of the building, where a favorable classification 
of the inmates can be maintained, where all the modern im- 
provements for in-door comforts and amusements and out- 
door exercise and recreation, and where competent medical 
and other attendance can always be procured, are necessary 
to attain the great object in view — a restoration to health 
and a sound mind. 

5 " For the most part all that can be expected in our county 
almshouses is to secure such provision for the chronic and 
incurable insane, as will meet the demands of a Christian 
humanity. To confine them in close and badly ventilated 
apartments, with scarcely any of the comforts which an en- 
lightened philanthropy would suggest — a condition in which 
they are too often found, — manifests such a failure of duty 
as to bring odium and shame upon the civilization of the 
age. 

^ In New York, a State institution was established in 
1865 under the name of the Willard Asylum for the Insane, 
for the reception, care and treatment of the chronic in- 
sane poor, who were then provided for in the several county 
poorhouses in the State. This institution is reported to be 
in successful operation. Whether the plan of separating 
this class of insane from the more acute and hopeful cases, 
and keeping them in different institutions is best adapted to 
the successful treatment of the insane population, is a ques- 



10 



don much discussed among experts of the present day. The 
medical superintendents of our insane hospitals, after a full 
and able discussion of the subject, came to the conclusion, 
that such a classification would be detrimental to the inter- 
ests of both classes. With such able authority against such 
a measure, I am not prepared to endorse the action of the 
New York Legislature, but prefer to leave the subject for 
further experience, and the candid consideration of philan- 
thropists." 

In 1872, the Board says in its report: "What the condition 
of the insane is, as a general rule, in the poorhouses of the 
State, we set forth clearly in our earliest report, and although 
there has been since then a manifest improvement in their 
condition and treatment, in several of the county establish- 
ments, it is impossible, from the circumstances which charac 
terize the whole arrangement, discipline, and government of 
such institutions, that these invalids can be otherwise than 
grossly neglected and foully wronged ; for, at the best, they 
are merely confined in places of detention, under the guar- 
dianship of a respectable overseer, who is wholly ignorant 
of their disease, and of the means necessary for its alleviation 
or its cure. We say, at the best. We hesitate to describe the 
reverse of the picture. It would exibit a scene of as cheer- 
less and uncomforted misery as the most bitter misanthrope 
could desire to look upon. It is hardly fair to claim that we 
have passed beyond the ignorance and barbarity of the mid- 
dle ages, in our consideration and care of this class of unfor- 
tunates, so long as we suffer the glaring abuses which are 
prevalent in our midst to continue unredressed. 

11 It is inconceivable to every reflecting mind, that abuses 
can be heaped upon the defenceless victims of this saddest 
of disorders, who should rather be the objects of the most 
spontaneous sympathy and the most willing kindness and 
consideration. The reasons that the chances of exposure are 
too remote to be estimated, and, as in the case of the child 
and the brute, that resistance is impossible, no doubt give 
impunity to the foul wrong-doing which the insane frequently 



11 



suffer. But the most fruitful cause of this evil is the incom- 
petency of those who are set over them. It is an evil almost 
irremediable, under the present system of appointments in 
the county almshouses and county jails. It generally hap- 
pens that these are based solely upon political considerations. 
Some useful partizan must be rewarded or in some way 
helped, and he is given an office, the duties of which he 
feels in no wise called upon to discharge ; having earned 
its perquisites by political services before he received it ; 
and, feeling his position secure, is quite naturally led to 
neglect his trust, by ignoring its most essential requirements. 
Unfitness of the highest measure is the character of such 
appointments generally ; and the victims in this case are a 
class of defenceless invalids, whose circumstances appeal 
with especial deserving to the highest claims of humanity and 
justice. 

" This mode of appointment should be abolished, rather 
than extended, and we earnestly invoke the action of your 
honorable bodies to revoke all legislation which favors it. 
The institutions established by the State and the counties, 
at so great a cost, and supported from year to year by large 
expenditure of the public funds, extracted often by onerous 
taxation, should be managed after a principle which will 
secure those objects to accomplish which they were respect- 
ively founded." 

As to the statistics in regard to this class of unfortu- 
nates, this Board hereby renews the offer made last year : 
" We are prepared, upon a call of either branch of the 
Legislature, to report upon the whole subject, stating the 
numbers and condition of this class, how they are now 
circumstanced, what proportion are probably chronic, and 
what curable cases, what additional accommodations are 
needed, and, if required, a scheme for realizing the demand 
which is made upon the State for the complete fulfilment of 
this imperative duty." 

But as to the number of these helpless sufferers, these de- 
pendent wards of the State, we may say beforehand, and 



12 



without reference to statistics, that, if the number is some 
thousands, their moral claim upon the State, as a matter of 
simple duty on her part, is multiplied so many thousand 
fold ; and if the number is small, there is the less excuse for 
shrinking from the performance of that duty — for making 
proper and complete provision for the care and treatment of 
them all. 

If these persons are to be allowed to live among us ; if 
they are not to be left, some to starve and perish, and others 
to spread their mischief far and wide, it is for 

THE INTEREST OF THE STATE 

that public provision should be made for their detention and 
maintenance ; and if they are to be detained and supported 
at the public expense, it is for the interest — the palpable, 
pecuniary interest of the State, that they should have appro- 
priate and comfortable accommodations, kind supervision, 
and the most patient and skillful curative treatment. This 
may be demonstrated in a few words. We may take two 
facts as well ascertained, and we believe they are admitted 
without a dissenting voice, (1) that under proper care and 
skillful treatment — as in our best hospitals — about 75 per 
cent, of recent cases of insanity will be cured in the first 
six or twelve months; (2) in poorhouses, not more than 
7 per cent, will be cured in the first year. Assuming these 
premises, and making the expense of each patient in the 
hospital twice what it would be in the almshouse, the gain 
in the first instance, under hospital treatment, is simply 
enormous. But this is not all. There are likely to be more 
cures afterwards under the skillful treatment than under the 
other. But suppose' there were not, and that all the remain- 
ing cases were incurable, there would remain, on one side, 
93 incurables to be maintained for life, and, on the other, 25 ; 
and if the ratio of expense were still double, the result 
would be in favor of hospital treatment as $50 to $93. That 
is to say, the latter method would be a continual saving to 
the State for many subsequent years of more than 46 per 



13 



cent, per annum. Nor is this all. It must be remembered 
that the greater part of 

THE INSANE POOR OWE THEIR POVERTY TO THEIR INSANITY, 

and not their insanity to their poverty ; and that, in losing 
their power to support themselves, they have lost also, in a 
very -large proportion of cases, the power to support families 
more or less numerous, who thus become dependent upon 
the public for their maintenance. The restored maniac re- 
sumes not only the enjoyment of a man's consciousness, but 
of a man's activity — the power of self-support ; and not only 
this, but of supporting by his industry those dependent upon 
him ; and every man who, by his enterprise, skill, and labor, 
supports himself and his family, contributes also to the sup- 
port of other men and their families. Such are the economi- 
cal advantages accruing to the State from a proper treat- 
ment of the insane poor, and their consequent restoration to 
mental health. 

But these unfortunate persons have claims upon the State 
higher far than mere considerations of economy. They are 
her wards, and she is bound by the dictates of 

SIMPLE JUSTICE AND IMPERATIVE DUTY 

to secure to them that humane, watchful, and patient care, 
and that skillful treatment, which will give the best pro- 
mise of their speedy restoration. If she chose to put them 
out of the way, like noxious beasts, or to let them alone 
to starve and die, she might say that charity and philan- 
thropy were no part of her mission, and ask who made her 
their keeper ? But when she has laid her hand upon them, 
put them in places of restraint and detention, and taken 
control and charge of them, she has made herself their keeper, 
and has bound herself so to treat them, as shall most conduce 
to their future well-being, as well as to her own. 
As to their actual 

CONDITION IN OUR COUNTY POORHOUSES OR PRISONS, 

we do not propose to weary the patience or offend the sensi- 
bilities of the honorable members of the Legislature by the 



u 



renewed recital of the more than three times thrice told tale 
of the woes and sufferings of this sorely stricken class of 
our fellow-citizens. That the story, with all its touching 
and terrible details, ranging from the intensely sad to the 
unspeakably horrible, should have been so often repeated, 
and yet the evil remain to so large a degree unremedied, 
instead of exciting our impatience, should raise our shame, 
and provoke us to immediate and energetic action. The 
story can never grow old or worn, as long as the subject- 
matter itself remains a fresh and living reality. There is 

BUT ONE VOICE IN THIS CASE. 

No intelligent person has ever made a general visitation of 
the prisons and almhouses of this State without being 
startled and almost overwhelmed by the forlorn and hopeless 
and sometimes horrible condition of their insane inmates. 
Those who some years since made a similar visitation in 
the State of New York pronounced their condition " de- 
plorable," and that State forthwith determined to apply an 
effectual remedy. The impressions made upon this Board by 
similar visitations in our own State have been laid before the 
Legislature in our reports from year to year. The shocking 
and sickening revelations, so graphically set forth in the me- 
morial of Miss Dix, presented to the Legislature of 1845, are 
not yet obsolete. There have been some improvements since 
made in some of these places. In the Philadelphia Alms- 
house, since then, there has been a great reform ; and in 
several other counties, well constructed hospitals for the sick 
and insane have been built ; but, with one or two exceptions, 
there is no special medical supervision or paid attendance at 
all. But in most parts of the State that condition remains 
now substantially the same as then. Indeed, without 

A TOTAL EEVOLUTION OF THE SYSTEM 

it is impossible greatly to improve it. There may be grave 
faults in the management of these poorhouses, some of which 
might be remedied, and others are probably incapable of 



15 



remedy; but the great fault — the fundamental cause of the 
evil, is in the system itself. If the administration were made 
as perfect as human infirmity allows, if the best superintend- 
ents or wardens, and the most faithful attendants were secured, 
while the evil might be mitigated, it would remain substanti- 
ally the same, until the system itself is changed. The 
remedy is not reform but revolution. 

We take leave to insert here the report made in the course 
of the present year by a member of this Board, of his per- 
sonal inspection of one of our county poorhouses. 

" With respect to the strictly pauper department of this 
almshouse, it bore a resemblance to other establishments. 
There was a scene of listless idleness and uselessness, without 
any superintending care. My attention was particularly di- 
rected by the general agent to the hospital for the insane, which 
was a separate building, upon the same ground with the other 
departments of the almshouse. I found these inmates suffer- 
ing for the want of almost every attention and consideration 
which are necessary to make life, even to the strong and 
hardy, tolerable. They have sufficient food, such as it is, at 
stated intervals, and the cells they occupy are furnished gen- 
erally with a rough bed and bed-clothes. These cells, too, 
are tolerably clean, for the cleansing of an establishment such 
as this, can be done without much difficulty, because there is 
always a sufficient number of paupers to do the work. W here 
the insane patients are considered violent or even disagree- 
able, it often happens that their cells are either neglected, or 
forcible measures are resorted to for the purpose of over- 
coming their interference, while their cells are being cleaned 
by the paupers. Though the board had previously called 
the attention of the directors of this institution to the im- 
perfect ventilation of the insane hospital, I found that even 
the means available for correcting the cause of this com- 
plaint, had been very imperfectly attended to. The conse- 
quence was that the atmosphere of most of the cells had 
become so vitiated and offensive that any person accustomed 
to the open air, would necessarily have fainted upon remain- 



16 



ing within the apartment for a moment of time. The in- 
mates seemed to have become used to this noxious atmos- 
phere, and they did not complain of it. On the contrary, 
the only complaint on their part was that made by an old 
woman, when her window was lowered a little to admit the 
fresh air. 



THE RESPONSIBILITY FOR THIS CHRONIC NEGLECT OP 
THESE CLASSES 

begins with the public and ends with the humblest attendant 
of the institution. So lost to all sense of decency have the 
insane in this hospital become, by reason of the failure on 
the part of those in authority to encourage a proper appre- 
ciation of self-respect among the inmates, that their habits are 
precisely like those of a brute. Consequently many of them 
are kept naked in their cells, from which they are drawn 
out each morning to be cleaned and their rooms put in order. 
The filthiest part of the litter — for their bedding consists 
wholly of straw — is then removed and its place supplied with a 
similar quantity of the fresh material ; when they are returned 
to their disgusting dens, there to pass another period of 
solitary wretchedness in an atmosphere whose odor exceeds 
in offensiveness, anything which the imagination can con- 
ceive. Through the gradual enfeebling of the higher attri- 
butes of their natures, some of these people come to be 
regarded by the other inmates as mere animals, and the 
young girls of the establishment look upon these naked men 
simply as they would look upon a horse or a hog. I am 
told that frequently two of the young female inmates of this 
insane hospital are called upon to clean these men each morn- 
ing as they are drawn out from their cells." 

The following statement of the condition of the insane in 
another poorhouse, is given on the well-sustained authority 
of another member of the Board. 

" In February last a visit was paid this almshouse, and an 
insane inmate was seen, — a young women over twenty years 
of age, whose whole dress consisted of a thin chemise with 



17 



short sleeves, a single skirt, and a pair of shoes. When 
brought before the visitors a borrowed cloak was thrown 
over her shoulders. She was blue with cold and utterly 
filthy in person. Her cell had the appearance of having 
undergone a recent hasty washing, but was pervaded with 
an odor loathsome in the extreme. On the day of this visit 
the thermometer fell to 14 degrees." 

"In March another visit was paid to the institution by 
several gentlemen in a body. Only one portion of the build- 
ing was visited, which is supposed to be devoted exclusively 
to women. In one cell was a young woman, the one already 
referred to. Her cell was without any furniture whatever, 
her bed consisted of one blanket, her clothing a ragged 
chemise open to her waist, and one scanty skirt and a pair of 
shoes. She was indescribably unclean, and alive with ver- 
min. Her cell reeked with a sickening odor, the result of a 
total absence of all conveniences for cleanliness. She shivered 
with cold, while in the presence of her visitors ; the ther- 
mometer standing, at the time several degrees below the 
freezing point. 

"Opposite to the cell, which we have very faintly described, 
was another. The short day had already faded into dusk, 
and as the light was thrown through the little aperture in 
the door, it fell upon two wretched women, both of whom 
were absolutely without a single garment to cover them. 
One of the poor creatures sat crouching in the corner with a 
small blanket drawn across her shoulders, while the other 
was crawling on all fours on the floor, without even this 
poor apology for any remnant of human decency ! There was 
not a particle of furniture in the cell; and there, on this 
wintry March night, in an atmosphere which the witnesses 
declare to have been utterly horrible, were these two human 
beings, brought down far below the level of our domestic 
brutes. 

"In an adjoining cell the visitors found a man lying on am 
old mattress, the only sign of furniture which they saw in 
either of the rooms inspected. They were informed that the 

[2] 



18 



inmate was a woman ; but upon one of the gentlemen calling 
to him, he sat up, and it was seen that it was a man. The 
attendant with some confusion explained that he must have 
been brought in while he was away. 

" We found the female insane department in a shocking 
condition ; so bad that it would be impossible to give a de- 
scription of the place on paper. In some cells there were 
two or more women confined ; some without any clothing, 
lying on the floor, without mattress, carpet or any thing else, 
except an old government blanket. The place had a horrible 
putrid odor. 

"We examined one woman who was quite young. I was 
afraid to go near her, as she seemed covered with vermin. 
We were all much shocked by the visit, and I think I shall 
remember it as long as I live." 

And the General Agent reports the following amongst 
many similar instances of abuses and neglects in the same 
establishments : 

"Insane totally neglected, morally, physically and medi- 
cally ; less attention is given to them, than would be given 
to the lowest animals; four are incapable of self care, con- 
fined in filthy cells ; one, a female, has great neighborhood 
notoriety, from sad incidents connected with her history; 
known as an intelligent, esteemed and attractive young lady, 
the daughter of a well-known inhabitant of the neighbor- 
hood, she fell a victim to the arts of the seducer. Insanity 
is alleged to have been caused by her disappointment. This 
occurred twenty-one years ago. The sad case is rendered 
still more painful by her present forlorn condition. A bed 
of straw, upon a damp dirty floor, into which the external 
light can find no entrance, is the only furniture. A seat, a 
chair or a bench, has apparently never been furnished ; the 
consequence of which is that the muscles of the lower ex- 
tremities, from the cramped position in which she was always 
found, have become permanently contracted ; so that the 
only movement of which she is capable, is one similar to 
that of a frog." 



19 



"An unusually large number of insane; many of chronic 
form, but quite a number of strongly marked cases, who 
were confined, and had been chained to the floor until re- 
leased by rny direction. A young girl of seventeen years of 
age confined in a gloomy cell; since removed by my request 
to the State Hospital, where she is gradually being restored." 

" Twenty-two insane, twelve are kept in close confinement, 
some in chains ; one always chained to the ceiling to prevent 
him from tearing his clothes ; some entirely nude ; at least 
six with straw litters ; not one of the twelve was ever removed 
into the open air. All confined in apartments opposite each 
other, a narrow corridor extending between them. The effect 
of this close proximity was, to make the day and night 
hideous, with the distressing shrieks and yells of the wretched 
and mal-treated madmen." 

11 Eight insane, one of whom handcuffed, one hobbled; one 
female confined to her room." 

11 One hundred and thirty-five inmates, four blind, one palsied, 
seven idiots; seven cells in the basement, with insane in each, 
in a revolting condition." 

" Twenty insane ; of these about eight were confined, not to 
their uncomfortable cells only, but restrained by iron fetters, 
long after the necessity had passed away. These were re- 
moved at my instigation and the doors of their cells were 
opened, to give them the benefit of the open air and exercise, 
with decided improvement in their condition." 



There are two difficulties in the way of checking 

THESE AND SIMILAR ABOMINATIONS: 

One is the unwillingness of the Directors of the poor to 
make expenditures for the comfort and well-being of the 
classes committed to their charge. They employ a steward 
whose principal requisite is that he shall be a good farmer, 
and whose attention must be given mainly to the farm of the 
institution, which may be, in extent, from 100 to 400 acres. 
As a consequence, the care and supervision of the human 



20 



beings, over whom this " steward" is placed, are lost sight of r 
to a great degree, in the apparently more important business 
of the farm, and are generally committed to the oversight of 
the paupers themselves. This is one evil. The other is ap- 
parent in the very unsuitable arrangement and construction 
in which the most helpless inmates — we mean the insane — 
are placed. In these structures it is a rare thing to find the 
sexes at all adequately separated, and, generally, they have 
no airing grounds, or even yards, to which the patients can 
repair and refresh themselves during the day. Therefore, 
they must remain in seclusion within their cells, from the 
beginning to the end of the year, existing in an atmosphere 
of great impurity, and constantly deteriorating in their men- 
tal and physical condition. 

In order to make the work of the Board effective, a cer- 
tain amount of 

EXECUTIVE POWER 

should be granted to it ; as has recently been conferred upon 
the New York Board of Public Charities, by the Legislature 
of that State. The public seem to be satisfied with 

HOUSES OF DETENTION: 

To get the various classes of unfortunates out of sight, 
seems to be the main object. The consequence is, that, as a 
general rule, the 

PRISON IS BETTER THAN THE POORHOUSE, 

as a receptacle for the insane. 

We may lay it down as a principle, at length become too 
plain to be controverted ; indeed as a point admitted on all 
hands, that poorhouses are not, and cannot be made fit places 
for the care and treatment of the insane, That they may 
receive proper treatment with any hope of recovery, they 
must be placed in hospitals or asylums, especially constructed 
and fitted up for their accommodation, with cheerful scenes 
within and cheerful scenery around, with skilled medical 
supervision and carefully selected and well trained attend- 



21 



ants; none of which conditions can be commanded in, or in 
connection with an ordinary county poorhonse. In con- 
nection with so large an establishment as the Philadel- 
phia Almshouse, where are gathered nearly one-half of all 
the pauper population of the State, a separate hospital of the 
required character may be provided and supported ; and we 
commend the humane and earnest spirit which is engaged in 
two or three of the larger communities, as, for instance, 
Berks and Lancaster Counties — in making adequate provi- 
sion for their insane. But in connection with the smaller 
almshouses of the several counties, and still more in connec- 
tion with the township arrangements for the care of the 
poor, such separate hospital accommodations are out of the 
question. They will never be established, and, if they were, 
they could not be maintained^ 

It will naturally be asked here, whether the State has not 
already established one or more 

GENERAL HOSPITALS FOR THE CARE OF THE INSANE, 

with a view of meeting this precise difficulty ? She has; and 
established them, professedly, for this very class of the 
insane, whose case we are now considering — for the insane 
poor, the insane who had been or are liable to be, gathered 
into the almshouses, or sent for safe-keeping to the prisons, 
in the several counties. The State has established these 
hospitals at no little expense ; 

BUT A VERY SMALL PERCENTAGE OF THE " POOR" INSANE 
ARE NOW IN THEM ; 

the great mass still remain in their former wretched, forlorn 
and hopeless quarters, a spectacle of misery or a butt of de- 
rision ; and an element of disturbance and irritation to the 
rest of the inmates. To the hospital at Harrisburg there 
were committed by the public authorities and courts during 
the year 1872, sixty-one poor patients and one hundred and 
thirty-eight " paying" patients were sent there by " friends." 
And of the four hundred and eight remaining on Dec. 31, 
1872, there were one hundred and seventy-nine supported by 



22 



" public authorities" and two-hundred and twenty-nine by 
"friends of patients." Again, of the one hundred and six- 
teen patients committed to this hospital during the nine 
months ending Sept. 30, 1873, eighty-four were " paying" and 
only thirty-two public or indigent insane" patients. 

Now it is manifest from the memorial of Miss Dix, in 
response to which the State Hospital was established, and by 
the express words of the law of 1845, coeval with its estab- 
lishment, that the original design of the hospital was what 
that of any such hospital ought, in all reason, — to be, to pro- 
vide for 

THE INSANE POOE. 

The law, section 25, declares that, in order of admission the 
"poor" shall have precedence of the "rich," (defined through- 
out the act "paying patients") and while the finances of the 
State do not permit ample provision for all cases of insanity, 
recent cases shall have precedence over cases of long stand- 
ing. If, under this law, the whole capacity of the hospital 
were devoted to the "poor," no objection, perhaps, could be 
made to sending away the incurable, after a reasonable period 
of trial, to make room for recent cases ; although it does not 
appear that such was the intention of the law, which seems 
to have merely laid down a " rule" to govern the order of 
admission to vacancies as they should be found to exist. 
But how should it happen that a majority of the inmates 
of this State institution should be " paying" patients ? 

How happens it that during the year 1872, sixty-nine per 
cent, of the patients admitted were paying patients, and only 
thirty-one per cent, public patients, and of those admitted 
during the nine months ending Sept. 30, 1873, the paying 
patients should increase to seventy-two per cent, with a 
corresponding reduction of public patients to twenty-eight 
per cent. Again, that at the close of the year 1872 this 
hospital should be occupied with fifty-five per cent, of pay- 
ing patients, and at the end of Sept. 30, 1873, with fifty six 
per cent, of the same class ? 



23 



Is it said that the incurables are sent away to make room 
for recent cases. But upon what authority? And, besides, 
if those sent to the hospital by their friends are recent and 
curable cases, in a larger proportion than the others, how 
comes it that a smaller percentage of these are discharged 
during the year ? Or, if they are incurable in a larger pro- 
portion than those committed by the public authorities, why 
are they not sent away in still greater proportion than the 
others, instead of being discharged in still less proportion ? 
Or, rather, why are they not all sent away; or rather kept 
away, as long as any of the others remain unprovided for ? 
We understand that, as a general rule, those committed to 
this hospital by the county authorities, if not " speedily" 
curable, are sent back to the helpless and hopeless life-doom 
of the poorhouses. On the other hand it is evident that 
"paying" patients may stay as long apparently as their 
comfort and the convenience of their friends require, and 
their means suffice for their support. Now we cannot but 
regard all this as a gross public wrong. The State has 
erected hospitals, 

NOT FOR THE "RICH," BUT FOR THE "POOR;" 

or, for the rich only when the poor should all be provided 
for. There is no need, even if it were right, that the State 
should erect hospitals at the public expense and out of the pub- 
lic taxes, for the accommodation of the rich ; they can or they 
will provide hospitals for themselves, including persons of 
moderate means as well as of considerable wealth. We 
maintain that the entire capacity of the State hospitals 
should be appropriated to the poor patients, before any such 
are refused admission or sent away under any pretext what- 
ever. The hospital at Dixmont, though a private charitable 
corporation, and only aided by the State, comes much nearer 
to our idea of the duty and the intention of the State in this 
regard, than that at Harrisburg. At the former, there re- 
mained at the close of the year 1872, only 117 private 
patients out of a total of 446 ; and on Sept. 30, 1873, only 



24 



23.89 per cent, of "paying" patients, or 108 out of a total 
of 452. 

And, again, of the 116 patients received into the State 
Hospital at Ilarrisburg, daring the nine months, ending Sep- 
tember 30, 1873, 84 of them or nearly three-fourths were 
"paying" patients; while, for the same period, out of 173 
patients admitted to the hospital at Dixmont, only 72 or 
about two fifths were "paying" patients. In other words 
30.79 per cent, more private patients were received into the 
State Hospital for the " insane poor," at Harrisburg, than 
into the private hospital for the insane (aided by the State) 
at Dixmont. 

It may be said, and perhaps with truth, that in many 
cases, the friends of insane patients, who can furnish the 
smaller sum required at the State Hospital for their support, 
would not be able to meet the heavier charges of a private 
asylum; and that, therefore, such insane patients must be 
thus admitted at the hospital or sent to the poorhouse. This 
idea seems highly plausible, and might at first receive favor 
from inconsiderate persons. But upon reflection it clearly 
appears unsound in theory ; and "upon experience it proves 
highly objectionable. If these patients are poor, why should 
precisely this class of poor patients have precedence of those 
who are still poorer ? And if they are rich — as by the terms 
of the statute all " paying " patients are, then the law ex- 
pressly gives the poor the precedence over them. Besides 
all these 

MIDDLE MEASURES OF GIVING PUBLIC AID TO THE POOR, 

are found in practice to be dangerous, and liable to great abuses 
on the part both of the recipients and t.he almoners of the 
public bounty. This case has proved itself, in our judgment, 
no exception to the general rule, 

It may be suggested that it has been thought well to have 
some paying patients in order to give 

RESPECTABILITY TO THE INSTITUTION. 

We can scarcely listen to the suggestion with patience, or 



25 



answer it with calmness. If all the poor were already pro- 
vided for and accommodated, the suggestion might pass ; al- 
though we should not make it. We should never propose 
that the State should tax herself to furnish hospital accom- 
modations to the rich in any case, whether by way of gratu- 
ity or of profitable speculation. But that is not the case. 
The poor are not all enjoying the care and treatment of tfie 
hospitals ; and shall they by the hundred and the thousand 
continue to languish into idiocy, or rave out their miserable 
lives in the cells of prisons with malefactors and felons, or in 
the more foul and wretched and hopeless receptacles of county 
poorhouses, in order that the hospital, which receives a few 
score of them, may be respectable, and its superintendent and 
officers may not find themselves in charge of an institution 
of mere paupers ? 

But, finally, it may be said, as a partial explanation of the 
great comparative rapidity with which the poor who are 
committed to the hospital are sent away, that a large part of 
them — those committed by the courts — are 

PERSONS CHARGED WITH CRIME 

who have been acquitted on the ground of insanity. Under 
the present law this explanation must, to a certain extent, be 
accepted ; but as these persons do not fall under the general 
class of the insane now under consideration, viz : those who 
have done no harm, and are free from any charge of crime, 
their case is reserved for consideration in the sequel. 

In the class of harmless insane, we include, it will be re- 
membered, all those who are legally charged with no acts of 
mischief, violence or crime ; as well, therefore, those, from 
whom such acts may be apprehended, as those, who, from 
their apparently gentle and inoffensive habits, are the objects 
of no such fear. Whether there be any of the insane so en- 
tirely harmless, that they can be trusted with absolute con- 
fidence, needing no special watch or restraint, some have 
doubted, and we need not decide or discuss the question ; for, 
in our clear judgment, there is no good reason why those who 






26 



may need greater degrees of watchful care and restraint* 
should not be treated in the same establishments with those 
who may need less, especially as the distinction is merely one 
of varying degrees. Even those who exhibit the greatest de- 
velopments of insane cunning for mischief, or are subject to 
the fiercest paroxysms of violence, or even of homicidal im- 
pulse, may be kept with proper classifications and internal 
arrangements, in the same institution with patients of the 
greatest gentleness and quietness of temper and demeanor. 
At all events, the proper hospital, with its more skillful su- 
perintendence and its more varied and thorough appli- 
ances, is, of all others, precisely the place for the former 
class ; for in poorhouses they can scarcely be kept at all, ex- 
cept as wild beasts ; and prisons are not places to which jus- 
tice or humanity can doom the innocent and helpless mad- 
man, however violent or dangerous. Yet are not such poor 
defenceless unfortunates, if adjudged too dangerous to go at 
large, and pronounced not curable, habitually sent to rave 
and rot in the foul dens of a poorhouse, or in the dungeons 
of a prison, there to be classed with robbers and murderers ? 
The importance of having the State Hospitals for the In- 
sane, subjected in this and in other respects, to the 

SUPERVISION OF SOME PARTY NOT CONNECTED WITH 
THEIR IMMEDIATE MANAGEMENT, 

so that the rights of the poor may be more surely, steadily, 
and systematically protected, we reserve for fuller considera- 
tion further on. But we cannot omit to observe here, that 
the State hospitals for the insane poor were not devised 
originally at the suggestion of experts ; but upon the pains- 
taking investigations and earnest petitions of Miss Dix and 
other benevolent persons ; and it is highly reasonable that 
their management, particularly as regards the receiving and 
discharge of patients, should be placed under the visitatorial 
power of disinterested parties, concerned only in securing the 
good to be derived from them for the defenceless insane poor. 
It is not to be supposed, however, that, under any manage- 



27 



ment, sufficient provision has yet been made in our State 
hospitals for 

ALL THE INSANE POOR IN THE COMMONWEALTH. 

Such provision ought to be made with all possible de- 
spatch. To propose to make it is no wild or visionary or 
extravagant scheme. It can be made in Pennsylvania as 
well as in New York. And we have already shown, that if 
we are to take care of the insane poor at all at the public ex- 
pense, the most economical method, irrespective of the 
demands of humanity, is to gather them into well-managed 
hospitals, instead of leaving them to linger out a miserable 
existence, hopeless of restoration, in prisons and poorhouses. 



We proceed now to consider the case of the two other 
classes of the insane. 

II. Those who, while sane, have committed acts of vio- 
lence or crime, but have either 

1. Become insane before arraignment, and so have never 
been tried ; or, 

2. Have become insane after conviction — insane convicts. 

3. Those who were insane at the time of committing such 
acts, and who, therefore, have been acquitted of crime on the 
ground of their insanity. These fall into various subdivi- 
sions to be mentioned hereafter. 

These two classes (1) those who stand charged or convict- 
ed of committing acts of violence or mischief while sane; 
and (2) those, who, although charged with crime for the com- 
mission of such acts, have been acquitted on the ground of in- 
sanity at the time of their commission, we place together, not to 
identify or confound them under any such denomination as 
"criminal insane," but rather in order the more emphatically 
to contradistinguish them. 

We begin with the case of the first of these classes ; and 
the question is, what disposition is to be made of the insane, 
who stand charged with, or have been convicted of, crime. 



28 



And first of those who may, with some propriety, be called 
" criminal insane," i. e, those who are charged with the com- 
mission of crime while sane, but who have become insane 
before arraignment ; and who, consequently, have never been 
convicted or tried. Their case is a somewhat delicate one 
in a legal as well as a moral point of view. According to 
legal principles, it would seem that their detention cannot be 
regarded as a punishment, for they are 



because they are charged with crime, .nor until they are 
found guilty upon trial and proof; but in their present con- 
dition they are not capable of pleading, and, of course, cannot 
be put upon their trial. Both as accused and as dangerous 
persons, they may properly be kept under detention and 
restraint ; but neither in fact nor in feeling, are they to be 
classed with felons or looked upon as tainted with crime, 
or as suffering a penalty. The fact of their present lunacy 
may be ascertained and established without the intervention 
of a jury, by the court itself, or by a commission appointed 
for the purpose ; but their having committed the criminal 
acts laid to their charge, and having committed them in a 
sound state of mind, can be ascertained and determined only 
by the intervention and verdict of a jury ; and any investi- 
gation or inquiry in that direction, instituted without such 
intervention, and without a hearing of the defendant, must 
necessarily be merely ex parte. And it is but the natural 
course of things, when a poor, friendless man, in his 
squalor and raggedness, is arraigned before a court, under 
the charge of some atrocious crime, accompanied with the 
confident allegation that, whatever may be his present mental 
condition, he was sane up to and at the time of the com- 
mission of the acts charged against him — it is but the natural 
course of things, that such a man is easily believed and 
presumed to be guilty ; and as society must at all events, be 
protected from his violence, whether sane or insane, he is 
consigned, side by side, with the convicts and felons, to the 
safe keeping of a prison cell. 



29 



But surely this ought not to be so — in all reason it ought 
not to be so. The State owes it to her own self-respect, to 
her own sense of justice, if not to her sentiments of human- 
ity, not to consign to the odium and punishment of crime, 
one of her citizens whose guilt has never been duly ascertained. 
What then shall be done with such persons? That is a se- 
rious question, and we shall endeavor to answer it. But, for 
the present, we only say, what is clear in the face of the 
matter, that they Ought 

NOT TO BE PLACED IN PKISON, 

or in any department of a prison ; and they ought to be 
placed where they not only will be effectually restrained 
from doing harm, but where they will have the best curative 
treatment, and the best prospect of being restored from their 
fearful malady. 

THE CASE OF INSANE CONVICTS, 

that is, of those who become insane after conviction, and 
while undergoing the punishment of crime, is different from 
the foregoing in several important particulars. For these 
the question of guilt is presumed to have been duly ascer- 
tained, and that they are suffering a just punishment. But 
in the midst of it, the mind loses its balance, and they be- 
come lunatics. Supposing this point to be ascertained and 
admitted — and the feigning of madness is pretty easily de- 
tected — then they are no longer responsible beings ; they are 
no longer proper subjects of prison discipline. It is utterly 
unreasonable and unjust, as well as inhuman, to continue 

TO INFLICT PUNISHMENT ON A MANIAC, 

who neither knows the reason, nor the end, nor the idea of 
rightful punishment. It is as absurd as to inflict indignities 
or violence upon the dead body of a criminal ; it is even 
more malignant, for the dead body has no sense of pain, but 
the maniac has. 

Besides, the State owes it to these helpless beings, who, 
while under her enforced control and guardianship, have 



30 



been smitten down with the most terrible of maladies — owes 
it to them as a mere matter of right, to give them the most 
skillful and promising curative treatment in her power, to 
save them, if possible, from confirmed and permanent 
mania or imbecility. To suffer a convict to become, from 
neglect, an incurable lunatic is worse, unspeakably worse 
than to dismiss him, at the expiration of his sentence, bereft 
of sight or hearing, or crippled by loss of limbs, or under 
some chronic bodily disease, in consequence of a reckless 
neglect of the proper medical care and treatment at the 
proper time. These irremediable losses and disabilities 
formed 

NO PART OF HIS SENTENCE. 

The State is bound, so far as she reasonably can, to dis- 
charge the convict, at the close of his term of punishment, 
in at least as good a condition — mental, moral, and physical 
— as that in which she received him. And, for failing in 
this, it will not do to seek an excuse in the small number, or 
the unworthy character of those who may suffer the wrong. 
The State, the very fountain of justice, she who takes it 
upon herself to punish wrongs, is bound to do no wrong to 
even one, and that one the meanest and most undeserving of 
her citizens. If there are but few convicts who need surgi- 
cal or medical treatment, whether for bodily or mental 
diseases, so much the less excuse is there, at least on the 
ground of economy, for neglecting them. 

Nor is this all. Even of those who are strictly insane 
convicts in the legal sense, and it is of those only we are 
now treating — i.e. of those who have been convicted of 
crime, as having been sane both at the time of the com- 
mission and the conviction, but being found insane after- 
wards — even of these it would be easy to show that by far 
the larger number were probably 

INSANE BEFORE CONVICTION, AND EVEN AT THE TIME OF 
THE COMMISSION 

of the alleged offence. It is the rich and respectable offender, 
who has friends and money, who can fee lawyers, who can 



31 



procure and array a crowd of witnesses in his behalf, who 
can protract his trial, clog the wheels of justice, and make 
interest by his audacity — it is he who too often escapes 
from merited punishment under a mistaken verdict of in- 
sanity. But 



who has been seized in some terrible act of atrocity, though 
committed under the impulse of actual insanity, is swiftly 
arraigned; and having nobody of any consideration or in- 
fluence, who personally cares for him, to stand by him or 
advise him ; without testimony, and, from his very unsound- 
ness of mind, perhaps, neither caring or knowing how to 
procure it, the evidence against him ample and clear, his de- 
fence provided by the court being merely professional and 
perfunctory, and, of course, under such circumstances, both 
hasty and imperfect, 

HE IS FORTHWITH CONVICTED AND SENTENCED TO THE 
PENITENTIARY OR THE GALLOWS. 

That this is no fancy picture, but a familiar matter of fact, is 
established by an abundance of proof. The uniform testi- 
mony of those who have charge of jails and penitentiaries, is, 
that almost all the so-called insane convicts under their 
charge were 



and so were almost certainly insane when tried, and probably 
so when they committed the offences for which they were 
convicted. 

Dr. Compton, in charge of the State Lunatic Asylum of 
Mississippi, says : M My own experience with insane criminals 
leads me to feel rather charitable towards them. I have 
had only three, and there have been circumstances connected 
with each of these cases, which lead me to think they were 
insane before committing the crime." 

Of the eighteen prisoners reported insane in the Eastern 



32 



Penitentiary in 1852, the Inspectors declare that "three had 
been placed in the penitentiary for safe keeping only, and 



and had already been confined in its cells, one nearly three, 
one over three, and one over seven years ! Eleven of the 
remaining fifteen were more or less insane when they were 
received into the penitentiary, two of the others became so 
a few months after, one a year, and one about four years 
after his reception. It will thus be seen that a large pro- 
portion were insane in a greater or less degree when first 
sentenced to the penitentiary ; and all but one or two of the 
rest developed it shortly after. The observation and ex- 
perience of the Inspectors have convinced them that the 
commission of crime is more frequently connected with 
mental disease than courts and juries (far less the public,) 
suspect : — hence the necessity of a prompt removal of all, 
who are found to be thus afflicted, to a place where proper 
treatment may restore them to mental health, and, as a con- 
sequence, to moral rectitude." Nor did this state of affairs 
cease at a later period. In their report for 1862, the Inspec- 
tors repeat that " There are yearly received into this Peni- 
sentiary insane convicts, insane or of diseased mental 
condition, on their admission." And again, in 1863 : " The 
Inspectors again ask the Legislature to require the State 
Lunatic Asylum to take insane convicts, or to make an ap- 
propriation for their medical treatment in the Penitentiary. 
When so many convicts are known to be insane on reception 
into this prison, this course is wise, humane and necessary." 
There are now about twenty of these " insane criminals " 
in the two penitentiaries, all of whom, according to the 
reports of the wardens, were insane or imbecile when re- 
ceived there. We insert here the report of Mr. Townsend, 
warden of the Eastern Penitentiary, made on this subject 
in October last : and, also, that of Capt. Wright, warden of 
the Western Penitentiary, made on November 24th. 



33 



REPORT OF WARDEN TOWNSEND. 

"E. S. Penitentiary, October 24, 1873. 
" To Geo. L. Harrison, Esq., 

11 President of the Board of State Charities. 

" Dear Sir, — I sent you a list some time ago of eleven 
persons confined in this penitentiary who were more or less 
insane. Since that time one has died, and one was pardoned 
by the Governor of the State, leaving now in confinement, 
nine. The one who was pardoned is now an inmate of an 
insane asylum. The nine who remain were all noted on our 
physician's book as 'insane, 1 or 'mentally uyisound" 1 at the 
time of admission. One was sent here twenty-three years and 
ten months ago, charged with assault and battery to kill, and 
sentenced not for a term of years, but for safe keeping ; he 
is a harmless imbecile. One was sent here from Luzerne 
couoty for ten years, on a charge of burglary and larceny. 
The object seemed to be, to rid the neighborhood of a 
troublesome fellow. One sent from Northampton county 
for ten years on charge of rape. One from Bradford county, 
charged with child murder, holding his own child under 
water, to see the effect of it, thus proving the insanity of the 
act ; his sentence is twelve years. A woman from Luzerne 
county, for shooting her husband, sentenced to eleven years, 
and eleven months. She is very crazy, and not a fit subject 
for penitentiary discipline. 

" One woman on several charges of larceny, sentenced to 
nine years. This woman has been an inmate of an insane 
asylum. One from Luzerne Co., for ' injury to rail road.' 
He piled lumber on the road to see how it would be scat- 
tered by the engine (a crazy man's trick.) One from Phila- 
delphia, for aggraved assault and battery, sentenced to seven 
years ; very weak minded on admission, and easily provoked 
to violence. One from Philadelphia, for wife murder, sen- 
tence ten years ; insane on admission. These individuals 
have received such care and attention as we were enabled to 

[3] . 



34 



give them, but we have no accommodations for insane 
patients — no rooms larger than the ordinary cells. They 
have had such medical care as our resident physician was 
able to give them, but we have no suitable nurses, nor place 
for any. I consider it very improper, very unkind, very 
cruel, to send insane persons to a jail or penitentiary. It is 
almost certain to fasten the malady upon them, until it be- 
comes irremediable. A hospital, with hospital appliances, 
is the only place for these poor stricken ones. 

" I think that a hospital for the insane should not be con- 
nected in any way with a prison, but be entirely separate, 
and under separate administration. 

" Could not a part of the Danville Asylum be thus used ? 

" Hoping these interrogatories are sufficiently answered, I 
remain, very truly and respectfully, thy friend, 

"EDWARD TOWNSEND, 
" Warden." 



REPORT OF WARDEN WRIGHT. 

" Allegheny, Pa., November 24, 1873. 
" Geo. L. Harrison, Esq., 

" President Board of Public Charities, 

" Dear Sir. — In your letter of 17th of October, you re- 
quest that I give you my views on the subject of the treat- 
ment of the criminal insane confined in penitentiaries and 
jails. 

" The subject has often been referred to in the Annual 
Reports of this penitentiary, and the Inspectors in their 
report for 1844, say, ' If, in the present pecuniary embarrass- 
ment of the Commonwealth, you cannot erect and endow a 
State Asylum for the insane, we must urge upon you the 
propriety and necessity of authorizing us to establish, 
within the prison walls, a hospital, for the reception of the 



35 



limited number of demented convicts which may unhappily 
come under our supervision. The occurrence is rare that 
they become so after they enter the penitentiary, but, in 
many instances, they are sent here after the commission of 
crime, because there is no other barrier to protect society 
from their demoniac depredations. There is a convict of 
this character now immured in one of our cells, for such is 
the sentence of the law. He came here in this lamentable 
condition.' In the report for 1857 it is said, ' convicts are 
often sent here whose proper destination should be the State 
Lunatic Hospital. Why they are sent here, whether for the 
purpose of supposed relief to the treasury of the county 
from which they come; from culpable ignorance of the law 
regulating the State Lunatic Asylum, or from the suggestion 
flattering to us, that we will take good care of them, and that 
society at large will be exempt from the dangers incident 
to a too close proximity to madmen ; it is a practice alike 
contrary to the policy of the law,- and the dictates of 
humanity.' 

" I have thus far made up, as briefly as practicable, from 
our own reports evidence that insanity has proven no bar to 
conviction and confinement in the penitentiary, and do not 
doubt further evidence could be given showing that harmless 
imbecile prisoners, have been received and discharged with- 
out further record, than such as was given to other prisoners. 

11 As having a direct bearing upon the views expressed in 
a, former report, that prisons are often used as asylums, the 
following extract from the report of the Warden of the 
Eastern Penitentiary for the year 1871, bears pertinent testi- 
mony, ' men are frequently sent to this penitentiary who 
.are not fit subjects for its discipline. During the year four 
men were received who were quite insane when admitted ; 
one in unsound mind ; and four of weak intellect. One of 
these insane prisoners died of tetanus, resulting from injuries 
inflicted upon himself shortly after his reception, and another 
committed suicide in one month after he came here. Of the 
nine hundred and eleven confined in 1871, twelve were in- 



36 



sane when admitted ; four of unsound mind ; two feeble 
minded and thirty-six of weak intellect, bordering on idiocy/ 

" In the annual report of the Eastern Penitentiary for 1872 
it is stated that two hundred and twenty- six convicts were 
received during the year, of whom one was of unsound 
mind, four were weak minded, fifteen were dull and two 
doubtful, making nearly ten per cent, of impaired intellect. 
Of the two hundred and seventeen convicts discharged, one 
insane, died, two were weak-minded and thirteen were dull r 
being nearly seven and a half per cent, of the discharged, 
impaired in intellect. 

" Under the provisions of the Act of 1852, four prisoners 
were removed in December, 1859, of whom the physician of 
the prison states, ' It would be absurd to assert that no case 
of insanity ever occurred in this prison, but, to show the 
probable effect of the discipline in these cases, I will refer to 
their condition on admission : — No. 1419 general good health, 
but appears to be of unsound mind ; circumstances had led 
to the belief of insanity, before he was brought to the prison. 
No. 1485 general good health. No. 1987 good health, but 
owing to his inability to speak English, his mental condi- 
tion was not recognized, but I now have no doubt he was 
insane when admitted. No. 2094 insane.' One of the above 
noted prisoners, No. 1485, was returned to the prison exactly 
three months after his transfer to the hospital, of whom it 
is afterwards entered that he died in the prison, insane, in 
January, 1862, after an imprisonment of ten years and nine 
months. The physician notes in his official report, ' upon 
his return here, he was still decidedly insane.' [Dixmont 
Hospital was not then open.] 

" The physician's record of insane prisoners as given to 
your Board and printed on page 14 of report for 1870, in 
brief, shows that one prisoner died in 1862, (previously 
noted as received in good health in 1851,) and seven others 
were received from 1863 to 1868, five were sent to Dixmont 
by order of the Governor, and two were discharged insane. 
All were insane or of feeble intellect when admitted. 



37 



" The physician notices eight cases of the various forms 
of insanity under treatment in 1871, who are stated to have 
been received insane ; four were transferred from the Eastern 
Penitentiary ; one had been in several insane asylums ; one 
when received was a mental and physical wreck (since dead ;) 
one had been held in jail a long time, owing to uncertainty 
is still confined, a complete imbecile ; one had been mentally 
as to his mental health. He was sent to Dixmont where' he 
impaired for several years. None of the cases originated in 
this prison. The report for 1872 contains further mention 
of the four cases remaining over from the preceding year. 

"The records of jails and other institutions within the 
Commonwealth, if culled from the official reports to your 
Board, would furnish abundant evidence of the need for a 
change in the present method of treatment of the criminal 
insane. 

" I doubt not you will recommend some important changes, 
and whether you favor the erection of a State Asylum for 
the ' Crimimal Insane,' or, endeavor to meet the present ex- 
igency, by procuring the setting apart of a wing in one or 
more of the existing State Lunatic Hospitals, I trust you 
will arrive at a satisfactory solution of this important ques- 
tion, and submit a plan wise in its details and ennobling in 
Its humanity. Very respectfully, 

"EDWABD S.WRIGHT, 
" Warden? 



We pass now to the consideration of the third class of 
insane persons, viz., of those who having committed acts of 
violence or mischief, are acquitted of crime on the ground 
of insanity. 

Here we presume that those persons who commit such 
acts under a partial aberration of mind, or a monomania, 
or a sudden impulse, which did not destroy or disable the 
power of rational, moral judgment; or under a temporary 



38 



delirous excitement, resulting from their own deliberate ac- 
tion, and the cause of which was under their own control, as- 
in a fit of intoxication, are 



and should not be acquitted of crime on that ground. But 
acts committed in a state of proper insanity, that is to say,, 

WHEN THE WHOLE RATIONAL FACULTY IS SO DERANGED, 

that the moral judgment, the power of discrimination be- 
tween right and wrong, is, by the visitation of Providence, 
utterly blotted out or partially paralyzed ; such acts, how- 
ever destructive or atrocious, cannot, without great impro- 
priety and even absurdity, be denominated crimes; and 
those who so commit them, cannot be classed among crimi- 
nals. An "insane criminal," as an expression intended to de- 
scribe a person as having committed a crime while in a state 
of insanity, is a contradiction in terms. 

How the facts are to be ascertained in these cases or what 
are the proper evidences, is not a point which concerns us at 
present ; such questions belong to courts, juries and experts;, 
but if the facts have been ascertained and adjudicated ; if 
there is admitted to have existed in the person arraigned,, 
such a general mental derangement as obliterated the moral 
judgment, or any other mania which involved the loss or 
subversion of the moral judgment and control, in relation to 
those acts to which the impulse or propensity points, 
whether such be judged and found curable or incurable, and 
whether the lunatic be adjudged dangerous or harmless; — 
then 

SUCH ACTS CANNOT BE RECKONED CRIMES, 

and the person who has committed them cannot, without 
gross injustice and inhumanity, be regarded or treated as a 
criminal. And such is presumed to be the case of all those? 
who are acquitted of crime on the ground of insanity. Yet 
under our laws and the administration of justice (!) in this 



39 



Commonwealth, numbers of these innocent and pitiable suf- 
ferers are so regarded and treated, — especially those who are 
tainted with the sin of poverty, as well as the crime of in- 
sanity. This is, at the present moment, one of the 

FOULEST BLOTS UPON" THE ESCUTCHEON OF OUR STATE, 

a blot, which, instead of being in process of gradual efface- 
ment, has been made darker and deeper by our more recent 
legislation. All the improvement and tendency to improve- 
ment in this respect, which resulted and promised to result 
from the just and merciful laws of 1845 and 1852, have been 
retracted and reversed by the law of 1861. 

The cases of insanity to which we now refer may be vari- 
ously classified, but the law fixes its attention chiefly on 
that form of mania, which is more or less dangerous, arjd 
requires more or less restraint for the protection of the com- 
munity, as well as for the safety of the patient. 

And that the case may be brought clearly and in one view 
under the eye of the members of the Legislature, we may be 
excused for here reciting somewhat at large the present pro- 
visions of our laws on this subject, as they stand in the stat- 
ute book. 



PROCEEDINGS AGAINST CRIMINAL LUNATICS. 
ACT OF 1836. 

[At the time this Act was passed there was no State Hospital for the insane, and for 
want of snch institutions they were sent to the penitentiaries and jails.] 

Section. 58. In every case in which it shall be given in 
evidence upon the trial of any person charged with any crime 
or misdemeanor, that such person was insane at the time of 
the commission of such offence, and such person shall be ac- 
quitted, the jury shall be required to find specially whether 
such person was insane at the time of the commission of 
such offence, and to declare whether such person was acquit- 
ted by them on the ground of such insanity, and if they 
shall so find and declare, the court before whom the trial was 



40 



iad, shall have power to order such person to be kept in 
strict custody, in such place and in such manner as to the 
said court shall seem fit, at the expense of the county 
in which the trial was had, so long as such person shall con- 
tinue to be of unsound mind. 

Sec. 59. The same proceedings may be had, if any per- 
son indicted for an offence shall, upon arraignment, be found 
to be a lunatic by a jury, lawfully impanelled for the pur- 
pose; or if upon the trial of any person so indicted, such 
person shall appear to the jury, charged with such indict- 
ment, to be a lunatic ; in which case, the court shall direct 
such finding to be recorded, and may proceed as aforesaid. 

Sec. 60. In every case in which any person, charged 
with any offence, shall be brought before the court, to be 
discharged for want of prosecution ; and shall, by the oath 
or affirmation of one or more credible persons, appear to be 
insane, the court shall order the prosecuting attorney to 
send before the grand j ury, a written allegation of such insanity, 
in the nature of a bill of indictment, and, thereupon the 
said grand jury shall make inquiry into the case, as in cases 
of crime, and make presentment of their finding to said 
court ; and if said grand jury shall affirm said written allega- 
tion, they shall endorse the same thereon, and, thereupon, 
the court shall order a jury to be impanelled to try the in- 
sanity of such person. Bat before a trial thereof be ordered, 
the court shall direct notice thereof to be given to the next 
of kin of such person, by publication or otherwise, as the case 
may require. And if the jury shall find such person to be 
iasane, the like proceedings may be had as aforesaid. 

Sec. 61. Provided, That if the kindred or friends of any 
person, who may have been acquitted, as aforesaid, on the 
ground of insanity, or in default of such, the guardians, 
overseers, or supervisors of any county, township, or place, 
shall give security in such amount as shall be satisfactory to 
the court, with condition that such lunatic shall be restrain- 
ed from the commission'of any offence by seclusion or other- 
wise, in such case it shall be lawful for the court to make an 



41 

order for the enlargement of such lunatic, and his deliv- 
ery to his kindred or friends ; or, as the case may be, to such 
guardian, overseers, or supervisors. 

ACT APEIL 14th, 1845. 

Sec. 8. The admission of insane patients, from the sev- 
eral counties of the Commonwealth, shall be in the ratio of 
their insane population : Provided that each county shall 
be entitled to send at least one insane patient. 

Sec. 9. Indigent persons and paupers shall be charged 
actual cost, &c, payable by counties. 

Sec. 10. The courts of this Commonwealth shall have 
power to commit to said asylum, any person, who, having 
been charged with an offence punishable by imprisonment 
or death, who shall have been found to have been insane in 
the manner now provided by law, at the time the offence was 
committed, and who still continues insane, and the expenses 
of said person, if in indigent circumstances shall be paid by 
the county, &c. 

Sec. 12. The several constituted authorities having care 
and charge of the poor of the respective counties, districts, 
and townships, shall have authority to send to the asylum, 
such insane paupers under their charge, as they may deem 
proper subjects, and they shall be severally chargeable with 
the expenses of the care, and maintenance, and removal to 
and from the asylum, of such paupers. 

Sec. 14. That if any person shall apply to any court of 
record within this Commonwealth, having jurisdiction of 
offences, which are punishable by imprisonment, for the 
term of ninety days or longer, for the commitment to said 
asylum of any insane person within the county in which such 
court has jurisdiction, it shall be the duty of said court to 
inquire into the fact of insanity in the manner provided by 
law ; and if such court shall be satisfied, that such person 
is, by reason of insanity, unsafe to be at large, or is suffer- 
ing any unnecessary duress or hardship, such court, shall, 



42 



on the application aforesaid, commit such insane person to 
said asylum. 

Sec. 15. In the order of admission, the indigent insane 
of this Commonwealth, shall have always precedence of the 

rich (in another place " paying patients ") and : — recent 

cases shall have precedence of those of long standing. 

ACT OF MAY 4th, 1852. 

Whenever in the opinion of the Inspectors of the Eastern 
Penitentiary, any of the prisoners therein confined, shall de- 
velop such marked insanity, as to render their continued 
confinement in said penitentiary improper, and their removal 
to the State Lunatic Hospital necessary to their restoration, 
it shall be the duty of the said Inspectors to submit such 
cases to a Board composed of the District Attorney of the 
county of Philadelphia, the principal physician of the Penn- 
sylvania Hospital for the Insane, at Philadelphia, and the 
principal physician of the Friends' Insane Asylum, at Frank- 
ford, in Philadelphia County, and in case a majority of them 
cannot at any time, when required, attend, a competent phy- 
sician, or physicians to be appointed by the Court of Quar- 
ter Sessions of the County of Philadelphia, in the place of 
such as cannot attend, upon whose certificate of insanity or 
the certificate of any two transmitted to the governor, and 
if by him approved, he shall direct that said insane prison- 
ers, shall be, by said Inspectors, removed to the State Luna- 
tic Hospital, there to be kept and properly provided for at 
the cost and charge of the county from which they were 
sent to the penitentiary, and if, at any time during the pe- 
riod for which any such insane prisoners shall have been 
sentenced to confinement in the Eastern Penitentiary, they 
shall in the opinion of the trustees of the said Lunatic Hos- 
pital be so far restored as to render their return to said pen- 
itentiary safe and proper, then the said trustees shall cause 
the said prisoner to be returned to said Eastern Penitentia- 
ry, due notice to be given to the clerk of the Court of Quar- 



43 



ter Sessions of the county from which such prisoners were 
sent to the penitentiary, of all such removals or transfers. 

ACT OF APEIL 8th, 1861. 

Sec. 1. When application shall be made under the 14th 
section of the Act of April 14, 1845, to which this is sup- 
plementary, to any court of this Commonwealth for the com- 
mitment of any person to the Pennsylvania State Lunatic 
Hospital, it shall be lawful for such court either to inquire 
into the fact of insanity in a summary way, &c. ; and in 
all cases, it shall be lawful for the several courts to use their 
discretion in sending insane persons to said hospital, or 
cause them to be confined elsewhere, as the said court may 
deem the case to be curable or otherwise. 

Sec. 2. No person shall hereafter be sent to the said 
Lunatic Hospital, under the 10th section of Act 14, April, 
1845, or any other law of this Commonwealth, who shall 
have been charged with homicide, or having endeavored or 
attempted to commit the same, or to commit any arson, rape, 
robbery or burglary, and have been acquitted of any such of- 
fences on the ground of insanity, or been proceeded against 
under the 59th or 60th sections of the Act of 1836, [see above] 
where the court trying the same shall be satisfied that it 
will be dangerous for such lunatic to be at large, on account 
of having committed or attempted to commit either of the 
crimes aforesaid, but such persons shall be confined in a pen- 
itentiary or the prison of the proper county. 

Sec. 3. In every case where a lunatic has been or shall 
be committed to said hospital, after an acquittal of any 
crime on the ground of insanity, or after an investigation in 
court under the 59th & 60th sections of the Act 13, June 1836, 
or on account of its being adjudged dangerous for such luna- 
tic to be at large; and in all cases where any lunatic has 
been, or shall be removed from either of the penitentiaries, 
or any prison of this Commonwealth, under the order of a 
judge or of any court it shall be lawful for the trustees of 



44 



said hospital with the aid of the superintending physician, 
to inquire carefully into the situation of the lunatic, and if 
a majority of the Board, including the physician, shall be 
satisfied that that there is no reasonable prospect of a cure 
of the insanity, being affected by a retention of the lunatic 
in the hospital they shall at the expense of the proper city 
or county, cause him or her, to be removed to the prison of 
the proper county or the penitentiary from which he or she 
was sent. 



Thus it appears that before 1845, — before the erection of 
a State Lunatic Hospital, (1) persons tried and acquitted of 
crime on the ground of insanity, (2) persons indicted for an 
offence and found to be insane when brought up for trial, 
and (3) persons charged with some offence and brought be- 
fore the court, to be discharged for want of prosecution, but 
being found in a state of lunacy, — provided they had no 
friends — were to be sent to the penitentiary, the county jail, 
or, if the county authorities should give the required 
guarantees, to the county poorhouse — as the court should 
judge most proper. 

By the Act of 1845 and the establishment of the State 
Lunatic Hospital, this state of things was at once and in 
prospect greatly improved. This alleviation was obtained 
upon the Memorials of Miss Dix and other philanthropic 
citizens, backed by the following representation from the 
judges of the criminal courts : 

The Memorial of Miss Dix to the Legislature, dated 
February 3d, 1845, contains the following certificate from 
members of the Judiciary in relation to the imprisonment 
of " insane criminals," Miss Dix prefacing its introduction 
with this paragraph : 

" Next after private families and poorhouses, the insane 
will be found in the jails and penitentiaries. On this subject 
the opinion of some of your jurists has been so explicitly 
declared, that I feel it but justice to the cause, to give this 
expression of theii sentiments place here." 



45 



" Philadelphia, March 5, 1839. 

" The want of an asylum for the insane poor often 
occasions painful embarrassments to the courts, when the 
defence in the criminal charge is insanity fully sustained by 
proof. Although the jury may certify that their acquittal 
is on that ground, and thus empower the court to order the 
prisoner into close custody, yet that custody can be in no other 
place than the common prisons, places illy qualified for such a 
subject of incarceration. We cannot doubt that the ends 
of justice would be greatly promoted, if such an asylum as 
the petitioners contemplated were established with proper 
regulations, and the courts were authorized to commit to it, 
all persons acquitted of crimes on the ground of insanity." 

(Signed) EDWARD KING, 

ARCHIBALD RANDALL, 
J. RICHTER JONES, 

Judges of the Court of Quarter Sessions * 

JAMES TODD, 
J. BOUVIER, 
R. T. CONRAD, 

Judges of the Criminal Sessio?is : 

CALYIN BLYTHE, 

Judge of the Twelfth Judicial District. 

Miss Dix adds, " It is believed that all the judges of the 
courts of the Commonwealth of Pennsylvania, having 
criminal jurisdiction, would coincide in the above opinion." 

But by the Act of 1861, now in force, the benefits which 
had been secured — which it was hoped would be secured, 
and which the judiciary thus earnestly desired might be 
secured, have been substantially annulled and frustrated : — 
for, as to the subsequent Act of April 20, 1869, — an Act 
intended to guard the commitment to, and secure a proper 
discharge from private hospitals, — it will be seen immediately, 
that they simply provide for the mode of procedure in one 
particular case, viz : in discharging a person who has been 



46 



acquitted of crime on the ground of insanity, at the time of 
its commission, but who is alleged now to be sane. It pro- 
vides for his "confinement," and then prescribes how the 
question of his sanity shall, before his discharge, be adjudi- 
cated. It is, in fact, legislation for the sane and not for the 
insane. [See Judge Brewster's "opinion" further on.] 

Under the first section of this Act (of 1861) a person, a 
man or woman, though free from the taint or charge of any 
crime whatever, having committed no act of violence or 
mischief — a poor, pitiable, harmless lunatic, 

MAY BE SENT TO A JAIL FOR INDEFINITE INCARCERATION ; 

and if, upon summary examination, such person is thought 
to be more probably incurable, it is more than suggested to 
be the duty of the court to send him to prison. And, if 
once sent there, his case is remediless, unless he can get 
through the provision of Sect. 3, and we shall see what pro- 
bability there is of that. 

Under the second section, no person charged with com- 
mitting or attempting to commit certain heinous crimes, and 
acquitted of the charge on the ground of insanity, shall, if 
the court judge it dangerous to be at large, be sent to the 
hospital at all, but he 

SHALL BE CONFINED IN THE PENITENTIARY OR THE PRISON 
OF THE PROPER COUNTY; 

that is to say, the only option left to the court is, either at 
once to discharge such a person and let him go at large, or 
to commit him to a hopeless imprisonment — hopeless, we 
say, unless he can run the gauntlet of Sect. 3. 

Under this third section — and this is the key to the right 
understanding of the present state of our whole legislation 
on this subject, — any lunatic who (1) upon trial, has been 
acquitted 

OF ANY CRIME WHATEVER, 

and however slight, or, (2) who has been indicted for any 
offence, and upon being brought up for trial, has been found 



47 



insane, or, (3) who, when brought up to be discharged for 
want of prosecution, is found insane, or, (4) who, though 
never charged with any crime or any act of violence or harm, 
has been adjudged dangerous, if allowed to go at large, — any 
lunatic of either of these four classes, who has, thereupon 
been sent by the order of any court, to a State hospital 
for the insane, — as well as any lunatic (5) who by the order 
of the Governor or by any provision of law, has been re- 
moved from any penitentiary or jail to the said hospital, 
may, upon the judgment of the trustees and superintending 
physician, of said hospital, that there is no reasonable 
prospect of a cure of his insanity, be, by tbem, and by 
their sole and uncontrolled authority, consigned to a help- 
less and hopeless 

IMPRISONMENT IN THE PENITENTIARY OR THE COUNTY JAIL. 

(Perhaps we ought to remark by the way that the last words 
of the section, " from which he or she was sent," may seem 
to confine the exercise of the power of the hospital authori- 
ties to the fifth class of persons before described ; but as, in 
that case the four other classes would have been enumerated 
in the section without any enactment in regard to them, it 
is presumed the Act should be interpreted as extending the 
same power of removing the parties from the hospital to 
prison, to all those four classes of cases also ; and so we be- 
lieve it has always been interpreted. But, perhaps it is to 
the credit of those who drew the Act, that that there should 
be marks of haste in its composition.) It is clear, however, 
that this act contains no authority for sending any patients, 
however incurable, to the county poorhouses ; they can be 
sent back only to the prison or the penitentiary. 

"We must ask your indulgence, gentlemen of the Legisla- 
ture, if we find ourselves compelled to speak harshly, or 
even disrespectfully, of the law of the land. We are ad- 
dressing legislators and not a jury. But what a law is this ! 
Is it possible that the members of our subsequent legisla- 



48 

t ur es — is it possible that you, gentlemen, have been fully 
aware of its extraordinary, of its atrocious provisions ! 
a law, which we are constrained to say, in the terrible cool- 
ness of its barbarous enactments — in its disregard not only 
of all the claims of humanity and justice, but of the simplest 
civil rights of every citizen, is, so far as we can find, with- 
out a parallel in the legislation of any other State of this 
Union, or of any Christian or civilized community in the 
world. By this law, not only are persons — men and women, 
who are admitted and solemnly adjudged to be innocent of 
all crime, — men and women, who have never even been 
charged with any act of violence or harm, — liable to be 
hopelessly incarcerated — incarcerated professedly for life; 
(for they are pronounced probably incurable, — and this is 
their only crime,) incarcerated in the common jail or the 
penitentiary, — incarcerated in the society of felons, — incar- 
cerated where they can have no proper care or treatment ; — 
not only this — but such persons liable to be so incarcerated, 
not upon the verdict of a jury of their fellow citizens, or the 
examination and sentence of any court of justice, but upon 
the dictum — the sole, peremptory, uncontrolled and irrever- 
sible dictum — of whom ? 

THE DICTUM OF THE TRUSTEES AND SUPERINTENDING PHYSI- 
CIAN OF A STATE HOSPITAL ! 

a tribunal unknown, elsewhere, to the constitution and 
laws of the State ; whose rescript overrides and reverses the 
solemn sentences of all the criminal courts of the Common- 
wealth ; and holds, in respect to them, the character of a 
judgment of a Supreme Court of Errors and Appeals; and 
the appeal to this court is made by the court itself: — and 
even this is not all ; but the court is the party interested 
to be rid of the care and burden of the poor speechless and 
defenceless victims, whose cases are to be passed upon ! 

Can anything be added to the extraordinary character of 
such a law ? Shall it be allowed any longer to disgrace our 



49 



statute book, and tarnish the fair fame of our beloved and 
honored State ? 

JSTo man, no one of us, gentlemen, can be sure that he will 
not become a helpless lunatic to-morrow. But does every 
citizen of Pennsylvania know that he is liable, without any 
fault of his own, to be sent at any time to the common jail 
for life long detention, by the sole and irrevokable authority 
and sentence of the superintendent and trustees of a State 
Lunatic Hospital ? And that in spite of, and reversal of, the 
contrary judgment and sentence of any and every court of 
justice, which may have passed, or which by law can pass 
upon his case. 

We beg here to disclaim, once for all, intending any per- 
sonal reference to or reflection upon the estimable gentlemen 
who have the charge of the State Hospitals for the insane. 
We doubt not they are honorable and conscientious men ; 
but they are men. The constitution of such a court of 
review must, we think, be admitted to be 

AN ANOMALY IN OUR LEGISLATION, 

and no less an anomaly that interested parties, however hon- 
orable and trustworthy, should be empowered to decide in 
their own case. And perhaps it is worth observing that, while 
a lunatic may be thus summarily removed from the hospital 
to the prison, by the simple flat of the hospital authorities 
alone, a lunatic could not so readily be removed from the 
penitentiary to the hospital. For this purpose the law of 
1852 presented a complex process. In order that a lunatic 
might be removed from the penitentiary to the hospital, the 
law provided that not only the inspectors of the penitentiary 
— honorable and conscientious men — should judge the con- 
tinued confinement of such lunatic in the penitentiary to be 
improper, and his removal to the State Lunatic Asylum 
necessary to his restoration, but the case must also be sub- 
mitted to a board composed of the District Attorney and 
either two superintendents of insane asylums or a compe- 
tent physician or physicians to be appointed by the Court of 

M 



50 



Quarter Sessions. Nor was their certificate of approval 
sufficient to secure the object: but that certificate must be 
transmitted to the Governor, and, if he approved, he might 
order the removal. So careful was the law in that case to 
guard the process against abuse. 

But we may be asked why we shonld cavil at what may 
be considered a theoretic anomaly, while it accomplishes the 
best results, and is the shortest and best way of accomplish 
ing them ? We answer by asking in return, 

WHAT HAVE BEEN THE EESULTS ? 

Have the courts, by them, been encouraged to send lunatics 
to the hospital, or, on the contrary, have they found that 
this is too often a roundabout way of sending them to prison ? 
But why is it that for more than twenty years the law has 
existed for sending certian lunatics from the penitentiaries 
to the hospital, and yet the experiment of doing so has been 
tried in the Eastern District of the State but once — indeed 
has not been tried at all in that district, for full twenty 
years past ? Is it said that the lunatics so transmitted very 
soon made their escape ? But if the hospital is by law to 
receive such lunatics, some part of it ought manifestly to be 
so constructed and arranged as to be suitable for their safe- 
keeping ; as has been done without difficulty or opposition 
in the hospitals of several other States. Have the hospital 
authorities sought to provide such construction and arrange- 
ments, in order that the ends of the law might not be de- 
feated ? Or, have they not rather sought and obtained. the 
counter provisions of the law of 1861, authorizing them to 
send all such lunatics back to prison ? Since which time it 
has been hardly thought worth while to commit any such to 
their care. Indeed it has been triumphantly said, on appar- 
ently good authority, (see Journal of Insanity, Oct. 1873, 
page 214) that, after the first experiment, i. e. before the law 
of 1861, as well as since, the Board of Trustees of the State 
Lunatic Hospital at Harrisburg declined receiving any more 
cases." That is to say, the Board of Trustees decided the 
question by their sole and ultimate authority — commission 



51 



or no commission — law or no law. We do not vouch for 
the fact, but it has been publicly so stated, without dissent, 
in the presence of the Superintendent of the Lunatic Asylum. 
We presume the refusal, if made, was a mere declaration and 
not an act ; but the statement, however interpreted, is highly 
suggestive. The Act of 1852 is still the law of the land — a 
law whose ends are eminently politic, just and humane, but 
can the authorities of the State Hospital be counted upon as 
ready cordially to concur in carrying out the provisions of 
that law, for the accomplishment of those ends ? 

The views of the judges of our criminal courts and of the 
Supreme Court of the State, upon present legislation in re- 
gard to the insane poor and the insane criminal will appear in 
their petitions to the Legislature, which we here introduce : 

To the Legislature of the State of Pennsylvania. 

" The judges of the criminal courts being greatly embar- 
rassed under the law of 1836, in the disposal of persons 
charged with crime, who were acquitted on the ground of 
insanity, being obliged to commit them to 'close custody;' 
the jails and penitentiaries being alone open to them, me- 
morialized the Legislature in 1839, in behalf of the establish- 
ment of a hospital for the ' insane poor,' and denounced the 
commitment of the irresponsible insane to the prisons of the 
State. By such influence and other humane and rightful 
effort, the Legislature, in 1845, established the State Lunatic 
Hospital at Harrisburg, under a law which gave proper pro- 
tection to the rights of the ' poor ' and the ' criminal insane.' 
This legislation satisfied the judges who bore the responsi- 
bility of disposing of such persons, and was also a clear ex- 
ponent of the public mind on the subject. 

" By more recent legislation, namely by the Act of April 
8th, 1861, the courts, having jurisdiction of such cases, are for- 
bidden to send them to the State hospitals, however irrespon- 
sible for crime, unless ' speedily curable,' if they are deemed 
dangerous persons to he at large ; and in every case where a 
lunatic may have been sent to the State Hospital, after an 
acquittal of any crime on the ground of insanity, the authorities 



52 



of such hospital may send such persons lo a penitentiary or 
jail, at the expense of the county where he belongs, unless 
they deem the case ' speedily curable.' Substantially the same 
provisions are contained in the Act of April, 1863, relating 
to the western part of the State. The undersigned, regarding 
the provisions of the Acts of 1861 and 1863, above cited, as 
an obstruction to the ends of justice ; and, being greatly em- 
barrassed in our administration of such causes, respectfully 
beg that the legislation be repealed, or such amendments 
made, as will relieve from unjust and injurious imprisonment 
with felons, the irresponsible class referred to, and which will 
also protect the ' insane poor ' in their rights, and enable the 
courts to comply with the laws, without violating a sense of 
right or a sentiment of humanity. 

" The Act of April, 1863, in relation to the commitment 
of the insane to the Western Pennsylvania Hospital provides 
for the return of insane criminals and persons acquitted on 
the ground of insanity, to the jail or penitentiary if deemed 
incurable." 

JOS. ALLISON, 
JAS. R. LUDLOW, 
WM. S. PEIKCE, 
THOS. A. FINLETTER, 
EDWARD M. PAXSON, 
Judges of Court of Quarter Sessions, Philadelphia Co. 

F. H. COLLIER, 
JAMES P. STERRETT, 
EDWIN H. STOWE, 

Judges of Court of Quarter Sessions of Allegheny Co. 

" We concur in the above recommendation," 

GEO. SHARSWOOD, 
HENRY W. WILLIAMS, 
JOHN M. READ, 

Nov. 28th, 1873. 

Judges of Supreme Court. 



53 

We turn to another description of the insane — to those, 
who without any charge or suggestion of crime, have, either 
as dangerous or simply as helpless lunatics, been placed in 
the county poorhouses. These may by law be committed 
by the county authorities to the State hospitals for the in- 
sane — How many of them have been so committed ? Does 
the management of these hospitals encourage and stimulate 
the authorities to send them there ? 

THEY NEED ENCOURAGEMENT AND STIMULUS ; 

for, as experience too constantly shows, those authorities are 
extremely liable to be led by the considerations of a false and 
short-sighted economy, to endeavor to make a cheaper provi- 
sion for the care and maintenance of their insane, 
than that furnished by the hospital. Are those whom they 
actually commit, sent back to them again, with a charge for 
the expense of both transfers ? If so, 

BY THE AUTHORITY OF WHAT LAW ARE THEY SENT BACK ? 

What law provides that the authorities of the hospitals may 
send any of their patients, or allow any of their patients, 
however violent or incurable, to be taken to a county poor- 
house ? Yet the simple fact is that while there are some 
five hundred of the insane poor, in our hospitals, sent from 
the county almhouses, there are more than twice that 
number 

RAVING OR LANGUISHING IN OUR COUNTY POORHOUSES, 

an incarceration much better fitted to make a sane man mad, 
than a madman sane. And of the two, if there is less dis- 
grace, there is also, in a majority of cases, less chance for 
comfort, and no better chance for recovery, in the poor- 
house than in the prison. So that it may be said upon a 
deliberate calculation, to be better, as regards comfort and a 
prospect of restoration, 

FOR AN INSANE PERSON TO BE CONVICTED OF CRIME, 

and sentenced to the penitentiary for a definite time, than, 
as an innocent lunatic, to be imprisoned in the poorhouse. 



54 



But, we may add that the great and irremediable defect in 
both the prison and the poorhouse, but especially in the 
latter, is the want of proper attendance, and of skillful medi- 
cal care. These poor creatures are not expected to recover. 
They are given over to utter hopelessness. 
And now, 

WHAT IS TO BE DONE ? 

To this question we would address ourselves with the full 
appreciation of the many and formidable difficulties 'with 
which the subject is encompassed. But we believe that 
there is no thoughtful person, who has made himself prac- 
tically acquainted with the facts, that does not fully concur 
in the judgment that no poorhouse can be a proper receptacle 
for the insane. We shall enter into no argument, therefore, 
to show that 

ALL THE INSANE POOR 

now gathered in the county poorhouses should, as soon as 
possible, be provided for in State lunatic hospitals, and 
transferred to them, to be there supported as the law may 
direct, unless any particular county has population enough, 
and insane poor enough, to render it advisable and feasible to 
establish and maintain a separate hospital for itself, with the 
full appointments and provisions for the best and most skill- 
ful care and medical treatment of the inmates, with a view 
both to their comfort and their care, as well as to the safety 
of the community. 

As to the other less numerous class, who have been com- 
mitted by the courts (or by the hospital authorities) to the 
jails or the penitentiaries ; including (1) those who, having 
been charged with the most heinous felonies, have been ac- 
quitted on the ground of insanity, (2) those who, on the same 
ground, have been acquitted of any offence whatever and 
however slight, (3) those who have been indicted for any 
offence, and upon being brought up for trial, have been 
found insane; (4) those, who, when brought up to be dis- 
charged for want of prosecution, have been found insane; 



55 



(5) those, who, though never charged with any act of crime 
or harm whatever, have been judged dangerous if allowed to 
go at large ; as well as (6) those who, having been convicted 
of crime, committed while they were presumed to be sane, 
have since become lunatics, — in regard to all these, it seems 
now to be universally conceded that, 

THE JAIL OR THE PENITENTIARY IS NOT THE PROPER PLACE 
FOR THE KEEPING OR CARE OF SUCH LUNATICS. 

The practical question then is what other provision is to 
be made for them ? 

The Act of May 4, 1852, had, as we have seen, provided 
that any of the prisoners confined in the Eastern Peniten- 
tiary, being found insane (thus, insane convicts as well, but 
not insane convicts only) might, by a certain process, be 
removed to the State Lunatic Asylum. In their report of 
the year following, the Inspectors of the Penitentiary inform 
us, that of eighteen persons proposed by them as candidates 
for removal, eight had been so transferred by order of the 
Governor, and they add : 

" The Inspectors cannot omit this opportunity of again 
calling upon the General Assembly, should the means pro- 
vided for this object be found in any way inadequate, either 
in the terms of the law authorizing the removal, or in the 
provision for the safe-keeping in the lunatic hospital, not to 
halt in the good work until it is carried into full effect. 
Let it no longer rest upon the fair fame of Pennsylvania, 
who claims to be foremost in the work of penitentiary re- 
forms, that insane men are imprisoned in the cells of her 
penitentiary for long years or for life. . . . Surely in this 
enlightened Christian age and country, the cells of the peni- 
tentiary should cease to be the abode of human beings with- 
out moral perceptions or responsibilities to fit them for the 
salutary effects of either penitentiary punishments or moral 
reform. The inspectors have gone more fully into this sub- 
ject than they otherwise would have done, from the fact that 
a state hospital has been been put into operation by the Legis- 



56 



lature for this enlightened and benevolent purpose. Its estab- 
ment lias been long needed." 

In their report for the next year (1854) the Inspectors re- 
mark that " the eight persons before alluded to, were the first 
so removed since the opening of the prison twenty-five years 
ago, as until last year no institution existed in Pennsylvania, 
as in other States, for the reception and treatment of persons, 
who, though insane, required punitive restraint. No other 
cases have since occurred requiring removal from the peni- 
tentiary. The State Lunatic Hospital is an establishment of 
the highest utility, — its purpose approved by the most en- 
lightened benevolence and sound policy. Every humane 
mind cannot but hope that it it will be fostered and encour- 
aged for the accomplishment of benefits to an increasing class 
of unfortunate people." They then proceed to a class who 
are sometimes included among the " criminal insane," in the 
following terms : — " As yet no complete provisions have been 
made for the reception and treatment of those insane who are 
sentenced to restraint of their liberty, because the fact of their 
unsound mind renders them irresponsible for the crimes 
charged against them. There are now four prisoners in the 
penitentiary thus confined ; their dangerous character, arising 
from homicidal mania, rendering them unsafe, unless under 
a cautious restraint. As they are in the penitentiary not as 
convicts, but here retained because of no other place of equal 
security, it is difficult properly to treat them for the confirmed 
malady under which they labor. The time will come when 
in the State Hospital, provision can be made for this class of" 
insane." # 

Nearly twenty years have elapsed, and these poor, wretched 
beings are still in jails and almshouses. 

The inspectors making the report in 1853, were John Bacon, 
Kichard Yaux, Hugh Campbell, Singleton A. Mercer and 
Charles Brown ; in 1854, Messrs. Bacon, Yaux, Mercer, An- 
drew Miller and Charles McKibben. 

Then came the law of 186 L ; which empowers the trustees 
and physician of the State Lunatic Hospital to send insane 



57 



persons committed to the hospital by the courts or removed 
to it from the penitentiary, back to the penitentiary from 
which they were sent, or to a prison to whioh- they were not 
committed by the courts, when there appeared no reasonable 
prospect of a cure. The result is that it is found a useless 
expenditure of pains and money, in many cases, for the courts 
to send to the hospitals insane men acquitted of crime, and 
always for the penitentiary to remove thither its prisoners or 
insane convicts, while authority resides in the hospital to 
forthwith send them back again. In anticipation of this re- 
sult, the inspectors of the Eastern Penitentiary, in their re- 
port of the following year (1862,) " respectfully suggest to the 
Legislature that provision by law be made requiring the State 
Lunatic Asylum to take insane persons convicted of crime into that 
institution. 1 '' And, in 1863, " the inspectors again ask the Leg- 
islature to require the State Lunatic Asylum to take ' insane 
convicts.' " The inspectors in 1862 and 1863 were Richard 
Vaux, Samuel Jones, M. D., Alexander Henry, Thomas H. 
Powers and Furman Sheppard. 

It is plain that these gentlemen, as well as the Inspectors 
of 1853 and 1854, judged it to be the wisest and most desir- 
able plan, in this as in other States, that provision should be 
made for the criminal insane and even for insane convicts 

IN CONNECTION WITH THE STATE HOSPITAL RATHER THAN 
WITH THE STATE PENITENTIARY. 

We append here, without comment as the documents tell 
their own story very clearly, the communications to this 
Board from the Inspectors of the Eastern and Western Peni- 
tentiaries requesting its intervention with the Legislature, 
for the modification or repeal of the obnoxious laws against 
the rights of the insane, which now disgrace our statute 
books. 

November 26th, 1873. 
" To the Board of Public Charities : 

" The Inspectors of the State Penitentiary for the Eastern 
District of Pennsylvania have heretofore in their reports 



58 



called the attention of the Legislature to the deplorable con- 
dition of the insane committed to the custody of that Insti- 
tution, and have suggested legislation which would relieve 
us from the pressure of a duty which we could not fulfil in 
providing for them proper care and medical treatment — and, 
which also would provide for these defenceless, and, for the 
most part, irresponsible, persons, a more rightful and suitable 
abode than a prison. We now most respectfully appeal to 
the Legislature, through your Board, to so amend the legis- 
lation of the Act of April 8, 1861, as will give effect to the 
former representations of the Inspectors, and place the class 
of the ' poor insane ' and the ' criminal insane ' in the 
more just and favorable position which they occupied under 
the law of April 14, 1845, which established the State Lun- 
atic Asylum at Harrisburg." 

EICHAED YAUX, 
THOMAS H. POWERS, 
ALEX. HENEY, 
CHAELES THOMSON JONES, 
JOHN M. MAEIS. 

"To The Board of Public Charities : 

" The Inspectors of the Western Penitentiary, desire to call 
the attention of the Legislature, through your Board, to 
the necessity of further and fuller provision by law, for the 
care and protection of the indigent and criminal insane. 

" In many of the annual reports of this Penitentiary, atten- 
tion has been directed to the fact, that insane persons have 
been convicted of crime and sent to prison. The following, 
from our report for 1867, briefly states the facts in the case, and 
in its conclusions, we trust, will receive your earnest co- 
operation. 

" We would ask the attention of the Legislature to the 
great necessity there is for such legislation as will secure to 
the insane convict a place in some State institution where he 
may be properly cared for. By special amended enactments 
of the law on this subject, no insane convict, who has been 



59 



committed to prison on the higher grades of crime, can be 
transferred to the hospital at Dixmont, ' unless by the 
verdict of the jury in the case there is reason to believe that 
a cure of such insanity may be speedily effected.' 

" If this institution is intended only for the benefit of the 
curahly insane, what is to become of the ill fated wretch who 
has no helper, and whose reason is declared to be '* clean 
gone forever.' 

" We hold that it is the duty of the State to make some 
speedy provision for his relief, either by the modification of 
existing laws, or the enactment of such statutes as will 
guarantee to him a humane and Christian protection." 

T. H. KEVIN, 
EGBERT H. DAVIS, 
JOHN DEAN, 
GEORGE A.KELLY, 
ORMSBY PHILLIPS, 

Inspectors. 

In like manner- the Secretary of the Massachusetts Board 
of State Charities, in his report for 1871, recommends, and 
in that for 1872 renews the recommendation, that a special 
" receptacle or institution be provided for insane convicts, and 
for insane persons, who, in a state of insanity, have committed 
or are disposed to commit violent acts ;" for which he gives 
his reasons at large, and then adds, "it is submitted that the 
construction of such a receptacle may perhaps be wisely 
made a part of the plan for a new hospital at Worcester. It 
can be made a separate building, surrounded by a wall, suf- 
ficiently removed from other buildings to avoid any un- 
pleasant associations, and yet near enough to have the bene- 
fit of the general superintendence of that institution." 

That is to say, as the Secretary immediately adds, the 
project of a new and (totally) separate institution for the 
class referred to, is sure to start some vexed question, with 
which it would not be well to embarrass the desired im- 
provement. The " convict insane " would give to it its dis. 



60 



tinctive character ; and then any proposition to admit to it 
others, not " convict insane," who could be better provided 
for in it, than elsewhere, would be resisted, as affixing to 
them the repute of a criminal class. Nor is it likely that it 
would, with its peculiar character, as well as its smaller 
numbers, be provided, in the long run, with a corps of 
officers equal in skill to those whose services are commanded 
by the other hospitals. For these and other reasons, it is 
better that provision should be made for the insane, who 
have committed or are pre-disposed to homicidal or violent 
acts, in buildings or apartments, properly arranged and pro- 
vided with means of security, 

IN CONNECTION WITH SOME ONE OF THE LUNATIC HOSPITALS." 

So much from the secretary. The Board itself, in its 
first report, had said, "There is still another class, the 'crimi- 
nal insane,' for whom special provision should be made. 
Formerly they were kept at the prisons, confined in cells ; 
but more recently they have been placed in the State hospi- 
tals. It is generally thought that this class of the insane 
should not be allowed to mingle with those who are 
free from crime, but should have apartments built ex- 
pressly for their accommodation. The most appropriate 
plan for an asylum, designed for this class of insane persons, 
would probably be 

AT ONE OF THE STATE HOSPITALS." 

The same subject was again referred to in their 5th & 6th 
reports ; and again it is added, if a proper building for "in- 
sane convicts" and others predisposed to violent acts should 
be provided in connection with one of the State Lunatic Hospitals, 
power should be given to this Board, to transfer from the 
other hospitals to the one where such provision is made, 
persons of the class referred to. " From the other hospi- 
tals," observe — not, '' from the prisons ;,, in Massachusetts 
there are no "insane criminals," nor " insane convicts" in the 
prisons. 



61 



We have referred to the injurious and wrongful effects of 
the Act of 1861, and we have seen the earnest counter- 
recommendations of the Inspectors of the Eastern Peniten- 
tiary and other just and honorable authorities. We have, 
ourselves, already pointed out 

THE DISASTROUS CONSEQUENCES OF THAT ACT; 

and now, to confirm our position, we beg leave to insert here 
the results of the experience and research, and the carefully 
drawn statements, of Judge Brewster, on this point, con- 
veyed to us in a letter dated October 10, 1873. 

"No. 214 West Washington Square. 
"Philadelphia, October, 10, 1873. 

"To Hon. Geo. L. Harrison. 

" President of the Board of Public Charities, 

"Dear Sir: 

"Your communication of August 14, in refer- 
ence to ' insane criminals ' was duly received and acknowl- 
edged. 

" With your permission the examination of the authorities 
which you desired was postponed until a recent date. 

"I have considered with some care the question you pro- 
pound, and the several Acts of Assembly to which you re- 
ferred me. I was induced to do this not only because of the 
respect due to your letter — but also because of the peculiar 
interest which ever attaches to the subject of the treatment of 
persons afflicted with the peculiar and distressing calamity 
of insanity. 

"Your favor refers me to a passage which is to be found in 
a communication addressed by your Board to the public. 

"As you invite a statement of my opinion as to its accuracy, 
it is proper that I should quote it at length — it is in these 
words : — 

" ' The sad and anomalous condition of 'insane criminals' 
' under the provisions of the Act of 1836 relating to this 
1 class, did not satisfy the public mind little as the public 



62 



' mind takes cognizance of such matters, and it found in 
' Miss Dix such an exponent of its wishes, as led to the leg- 
' islation of 1845, which established the State Lunatic Hos- 
' pital at Harrisburg, at which provision was made for the 
'reception of this class of the insane, in community with 
' the other patients. So largely did this feature interest the 
' public that it was the common thought that this Institu. 
1 tion was created for the special care of this class. The 
' Act of 1861 practically nullified this legislation and since 
' then, a great wrong has been imposed upon them, which 
' this Board is endeavoring to remove. Very many of 
' them are consigned to the public jails. While wholly ir- 
' responsible in the eyes of the law, they are dealt with by 
'the law, as convicted criminals. We maintain that under 
' the law of 1861, the wisdom and humanity of our able and 
' excellent judges are not competent to make any other dis- 
1 position of them." ' 

" You ask me to give my 'professional opinion upon the 
' accuracy of the statement' just quoted. 

" Save for your request, which implies that some one has 
ventured to doubt the correctnesss of your narrative, I should 
not have supposed it possible that it needed confirmation. 

" My first impression was decidedly in favor of its entire 
truth and my subsequent examination of the law has con- 
firmed my original conviction. 

" By the Act of June 13, 1836, it was provided that upon 
the acquittal of a defendant in a criminal case 'upon the 
ground of insanity,' the court should have the 'power to 
' order such person to be kept in strict custody in such place 
' and in such manner as ***** should seem fit * * so long 
'as such person should continue to be of unsound mind.' 
(Act of June 13, 1836, § 58, P. L. 1836, page 603. 

" The like proceedings were authorized if the defendant 
were upon arraignment found to be a lunatic and even where 
he was about to be discharged for want of prosecution. 

" Prior to 1841 there was no place in which such unfortu- 
nate persons could be 'kept in strict custody, except prisons 



63 



and penitentairies. The private asylums were evidently not 
contemplated by the law, and were probably under no obliga- 
tion to receive any person sent to them by the courts. 

" March 4, 1841, Governor Porter approved an Act ' to 
1 establish an asylum for the insane of this Commonwealth.' 
This statute reflects great credit upon the gentleman who 
drafted it, and upon the Legislature and the Governor who pas- 
sed and approved of it. It established " a public asylum for 
'the reception and relief of the insane of this Commonwealth.' 
The Governor was to appoint three commissioners to pur- 
chase a site and to erect a building for the accommodation 
of 300 patients and necessary offices, at an expense not ex- 
ceeding $120,000. 

" The 8th section of said Act was designed to remedy the 
evil you refer to as existing under the statute of 1836. It 
provided : — 

" 'That the proper courts of this Commonwealth shall 
'have power to commit to said asylum, any person who 
'having been charged with an offence punishable by im- 
' prisonment or death, shall have been declared by the ver- 
' diet of a jury or otherwise, to the satisfaction of the court, 
' to have been insane at the time the offence was committed, 
, and who still continues insane.' 

"The prior Act of 1751 had contained no such provision. 
The Act of 1841 removed the blot upon our system of con- 
fining insane persons as criminals. 

"So far as I have been able to discover, there was no 
change in this system for many years. It evidently met with 
the support of the people. By Act approved by Governor 
Shunk, April 14, 1845, a hospital was established at Harris- 
burg (P. L. 1845 p. 442.) 

" The 10th section of this statute repeats the humane pro- 
vision of the Act of 1841. 

" March 18, 1848, Governor Shunk appoved the Act incor- 
porating the Pittsburg Hospital. (P. L. 1848, p. 218.) By a 
supplement to this charter approved by Governor Pollock, 
May 8, 1855 (P. L.1855 p. 512) the provisions of the Act of 
1841 were extended to that institution. 



64 



"Provisions for the removal of insane persons from prisons 
and penitentaries to insane asylums were repeated by the 
Acts of May 4th, 1852 (P. L. 1852, p. 552,) and March 24th, 
1858 (P. L. 1858, page 151.) 

"So the law stood from 1841 to 1861. During those 
twenty years, the courts and all classes of citizens were 
satisfied with the propriety, justice and necessity of these 
laws. 

"April 8, 1861, a statute was approved which prohibited 
the commitment to the Pennsylvania State Lunatic Asylum 
of any person charged with certain crimes therein enumer- 
ated. It, however, contained a humane proviso which left 
the power of commitment with the courts where they were 
satisfied that there was c reason to believe that a cure of the 
insanity might be speedily effected' (P. L. 1861, page 249.) 
But a subsequent section authorizes the trustees and the super- 
intending physician to reverse the order of the court, for if 
they are satisfied ' that there is no reasonable prospect of a 
' cure' * * . * they may in all cases cause the patient to be re- 
1 moved to the prison of the proper county or the penitentiary- 
' from which he or she was sent.' 

"It is, therefore, unfortunately true as stated by you, that 
the Act of 1861 practically nullifies the humane legislation of 
former years, and that since 1861 a great wrong has been im- 
posed upon a class of unfortunate persons who although not 
responsible to the law, are yet subject to confinement in prisons 
and penitentiaries as felons. These views are not affected in 
any wise by the Act of April 20, 1869, (P. L. 78) for the offi- 
cers of the State asylums are not embraced within its provi- 
sions. The Act of 1861 stands unrepealed. 
I am, very respectfully yours, 

" F. CARROLL BREWSTER." 

In a large number of our sister States, constitutional provi- 
sion has been made to secure appropriate legislation in behalf of 
the insane ; but in order to bring the whole subject more fully be- 
fore the Legislature, in all its bearings, or, at least, in a great 



65 



variety of points of view, we take leave to introduce here the 
legislative provisions of a number of States as to insane per- 
sons, charged or convicted of crime ; premising that we have 
examined the constitutions and laws, together, of thirty-three 
States (all that we have been able to reach,) in relation to the 
insane, and in all cases their rights have been tenderly pro- 
tected — and the legislation in behalf of the class to which we 
are now directing your attention, with the single exception of 
Pennsylvania, is invariably of the most humane character. 

LEGISLATION OF OTHER STATES IN RELATION 
TO INSANE CRIMINALS. 

ARKANSAS. 

A person that becomes insane or lunatic after the commis- 
sion of a crime or misdemeanor, shall not be tried for the 
offence during the insanity or lunacy. 

If, after verdict of guilty and before judgment pronounced, 
such person becomes insane or lunatic, then no judgment shall 
be given while the insanity or lunacy shall continue. 

If, after judgment and before execution of the sentence such 
convict becomes insane or lunatic, if the punishment be capital 
or corporal, the execution thereof shall be stayed until the 
recovery of such convict from such insanity or lunacy. 

CONNECTICUT. 

That section two hundred and forty- three of the Act 
concerning; crimes and misdemeanors be amended bv erasing: 
from the fourth line thereof the words the " common jail " 
and inserting in lieu thereof the words " the General Hospital 
for the insane of the State of Connecticut." 

GEORGIA. 

It shall be the duty of the physician to the penitentiary of 
this State, when he discovers that any one of the convicts in 
said penitentiary has become lunatic or insane, to certify the 
same to the principal keeper of said penitentiarv, and it shall 

[5] 



6Q 

be the duty of said principal keeper, upon the receipt of such 
certificate, to transfer said convict to the lunatic asylum of 
this State, and shall send together with such convict a copy 
of said certificate, together with the day on which the term 
of service of such convict will expire in said penitentiary, and 
the county from which he was sentenced. 

LOUISIANA. 

Whenever any person arrested to answer for any crime or 
misdemeanor before any court of this State, shall be acquitted 
thereof by the jury, or shall not be indicted by the grand 
jury, by reason of the insanity or mental derangement of such 
person, and the discharge or going at large of such person, 
shall be deemed by the court to be dangerous to the safety of 
the citizens or to the peace of the State, the court is authorized 
and empowered to commit such person to the State Insane 
Hospital or any similar institution in any parish within the 
jurisdiction of the court : There to be detained until he is 
restored to his right mind or otherwise delivered by due 
course of law. 

MAINE. 

When any person is indicted for a criminal offence, or is 
committed to jail on a charge thereof by a justice of the peace 
or judge of a police or municipal court, any judge of the court 
before which he is to be tried when a plea of insanity is made 
in court, or he is notified that it will be made, may in vacation 
or term time order such person into the care of the superin- 
tendent of the insane hospital, to be detained and observed by 
him till the further order of the court, that the truth or falsity 
of the plea may be ascertained. 

When the grand jury omits to find an indictment against 
any person arrested by legal process to answer for any offence 
by reason of his insanity, they shall certify that fact to the 
court ; and when a traverse jury for the same reason acquits 
any person indicted, they shall state that fact to the court 






67 



when they return their verdict ; and the court by a precept 
stating the fact of insanity, may commit him to prison or to 
the insane hospital till restored to his right mind or delivered 
according to law; but he shall only remain in prison till provi- 
sion can be made for him at the hospital and then removed 
thereto . 

When an inmate of the State prison becomes insane, the 
warden shall notify the Governor of the fact and he, with the 
advice of counsel, shall appoint a commission of two or more 
skillful physicians to investigate the case, and if such inmate 
is found insane by their investigation, he shall be sent to the 
insane hospital until he becomes of sound mind ; and if this 
takes place before the expiration of his sentence, he shall be 
returned to prison; but if after, he shall be discharged free. 
The expenses of the commission, removal, and support shall 
be paid by the State. 

MINNESOTA AND WISCONSIN. 

When any person, indicted or informed against for an of- 
fence, shall on trial be acquitted by the jury, by reason of in- 
sanity, the jury in giving their verdict of not guilty, shall 
state that «is was given for such cause, and thereupon if the 
discharge or going at large of such insane person shall be 
considered by the court manifestly dangerous to the peace and 
safety of the community, the court may order him to be com- 
mitted to prison, or may give him into the care of his friends, 
if they shall give bonds with surety, to the satisfaction of the 
court, conditioned that he shall be well and securely kept ; 
otherwise he shall be discharged. 

OEEGON. 

If the defence be the insanity of the defendant, the jury 
must be instructed if they find him not guilty on that ground, 
to state that fact in their verdict, and the court must there- 
upon, if it deems his being at large dangerous to the public 
peace or safety, order him to be committed to any lunatic 



'68 

asylum authorized by the State to receive and keep such per- 
sons, until he become sane -or be otherwise discharged there- 
from, by authority of law. General laws Oregon, page 
469 § 170. 

NEW JERSEY AND NEW YORK. 

When a person shall have escaped indictment or have been 
acquitted of a criminal charge upon trial, on the ground of 
insanity, upon the plea pleaded of insanity or otherwise, the 
court being certified by the jury or otherwise of the fact, 
shall carefully inquire and ascertain whether his insanity in 
any degree continues, and if it does, shall order him into safe 
custody, and to be sent to the asylum. 

If any person in confinement, under indictment or under 
sentence of imprisonment, or for want of bail for good beha- 
vior * * shall appear to be insane, the judge of the circuit 
court of the county where he is confined shall institute a 
careful investigation, call two respectable witnesses, physicians 
and other credible witnesses, invite the prosecutor of the pleas 
to aid in the examination, and if he shall deem it necessary, 
call a jury, and for that purpose is fully empowered to compel 
the attendance of witnesses and jurors, and if it be satisfacto- 
rily proved that he is insane, said judge may discharge him 
from imprisonment, and order his safe custody, and removal 
to the asylum, where he shall remain until restored to his 
right mind, and then if the said judge shall have so directed, 
the superintendent shall inform the said judge and the county 
clerk and prosecutor of the pleas thereof, whereupon he shall 
be remanded to prison, and criminal proceedings be resumed, 
or otherwise be discharged. 

Persons charged with misdemeanors, and acquitted on the 
ground of insanity, may be kept in custody and sent to the 
asylum in the same way as persons charged with crimes. 

NEW YORK. 

An Act to organize the State Lunatic Asylum for insane 
convicts, passed April 8th, 1858. 



69 



Sec. 1. The building now being erected on the prison 
grounds at Auburn, for an asylum for insane convicts, shall be 
known and designated as the "State Lunatic Asylum for insane 
convicts." 

[After defining the method of administration, the statute' 
proceeds ; ] 

Sec. 8. "Whenever the physicians of either of the State pris- 
oners of this State shall certify to the inspectors, that any convict 
is insane, they shall make immediately a full examination into the 
condition of such convict, and shall cause such convict to be ex- 
amined by one of the physicians of the State Lunatic Asylum at 
Utica, and if satisfied that the said convict is insane, or that 
there is probable cause to believe such convict to be insane, 
they shall order the agent and warden of the prison where 
such convict confined, forthwith to convey such convict 
to the State Lunatic Asylum for insane convicts, and to de- 
liver the said convict to the superintendent thereof, who is 
hereby required to receive said convict into the said asylum, 
and retain him there so long as he shall continue to be insane, 
and no convict who has been committed to said asylum as 
insane, shall be discharged from said asylum by reason of the 
expiration of the term for which he was sentenced, unless the 
relatives of such convict shall produce to said superintend- 
ent satisfactory evidence of their ability to maintain such con- 
vict, and shall execute and deliver to said superintendent an 
agreement in writing that such convict shall not be a charge 
upon any public charity, if such convict shall continue to be 
insane at the expiration of the time for which such convict 
was sentenced. 

ACT OF MAY 21, 1873. 

No person, association or corporation shall establish or 
keep any asylum, institution, house of retreat for the care, 
custody or treatment of the insane, or persons of unsound 
mind, without first obtaining a license therefor from the Board 
of State Charities ; provided, that this section shall not apply 
to any State asylum or institution, or to any asylum or insti- 



70 



tution established or conducted by any county or by any city 
or municipal corporation. 

The said Board mab revoke the license of any asylum or 
institution, issued under the provisions of this Act, for 
reasons deemed satisfactory to said board ; but such revoca- 
tion shall be in writing and filed, and notice given in writing 
to the person, association or corporation to whom such license 
was given. 

ACT OF JUNE 7, 1873. 

If any inmate of any such almshouse, when admitted, is 
insane, or thereafter becomes insane, or of unsound mind, and 
the accommodations in said almshouse are not adequate and 
proper, in the opinion of the said Secretary of the State Board 
of Charities, for his treatment and care, the said Secretary 
may cause his removal to the appropriate State Asylum for 
the Insane and he shall be received by the officer in charge 
of such asylum and maintained therein until duly discharged. 

OHIO. 

If any person in prison shall, after the commission of an 
offence, and before conviction, become insane * * * an ex- 
amining court may be called in the manner provided in the 
Act entitled * * * and if such court shall find that such 
person became insane after the commission of the crime or 
misdemeanor of which he stands or charged indicted, and is 
still insane, the said court shall proceed and the prisoner 
shall for the time being, and until restored to reason be dealt 
with in like manner as other lunatics are required to be after 
inquest had, provided, however, that if said lunatic be dis- 
charged, the bond given for his support and safe-keeping 
shall also be conditioned that said lunatic shall when restored 
to reason answer to said crime or misdemeanor and abide the 
order of the court in the premises ; and any such lunatic 
may, when restored to reason, be prosecuted for any offence 
committed by him previous to such insanity. 

If any person, after being convicted of any crime or mis- 
demeanor, and before the execution in whole or in part of the 



71 



sentence of the court, become insane, it shall be the duty of 
the Governor of the State to inquire into the facts, and he 
may pardon such lunatic, and commute or suspend for the 
time being the execution in such manner, and for such a 
period as he may think proper, and may by his warrant to the 
Sheriff of the proper county, or Warden of the Ohio Peniten- 
tiary, order such lunatic to be conveyed to the asylum and 
there kept until restored to his reason. If the sentence of 
any such lunatic is suspended by the Governor, the sen- 
tence of the court shall be executed upon him after such 
period of suspension hath expired, unless otherwise directed 
by the Governor. 

RHODE ISLAND. 

If upon examination a judge is satisfied that the person 
thus imprisoned is insane or idiotic, he shall have the power 
to order the removal of such prisoner from the State prison 
or jail aforesaid, to be detained in the State Asylum for the 
Insane, if he can be there received, or if not in the Butler 
Hospital. 

Such order of removal shall be for and during the term 
of said prisoner's sentence, and be directed to the Sheriff of 
the county in which such prisoner stands committed. 

Any person removed as aforesaid, upon restoration to reason 
may, by an order of either of the judges of the Supreme Court 
in his discretion be remanded to the place of his original con- 
finement, to serve out the remainder of his term of service. 

MASSACHUSETTS. 

The physician of the State Prison, as chairman with the 
Superintendents of the State Lunatic Hospital, shall consti- 
tute a commission for the examination of convicts in said 
prison alleged to be insane. Each commissioner shall receive 
for his services in such capacity his travelling expenses and 
three dollars a day for each day he is so employed. 

The Commission shall investigate the case, and if in the 
opinion of the majority of them, the convict has become in- 



72 



sane and his removal would be expedient, they shall so re- 
port, with their reasons, to a judge of the Superior Court, 
who shall forthwith issue his warrant under the seal of that 
court, directed to the Warden, authorizing him to remove 
the convict to one of the State lunatic hospitals, there to be 
kept till in the opinion of the Superintendent and Trustees 
thereof, he may be recommitted consistently with his health. 
When a convict in the prison appears to be insane, the 
Warden or Inspector shall give notice to the chairman of said 
commission, who shall forthwith notify the members thereof 
to meet at the prison. 

NEW HAMPSHIRE, 

The Governor, with the advice of the Council, may remove 
to the Asylum, to be there kept at the expense of the State, 
any person confined in the State prison who is insane. 

SOUTH CAROLINA. 

Any judge of the circuit court is authorized to send to the 
lunatic asylum every person charged with the commission of 
any criminal offence who shall upon the trial before him 
prove to be non compos mentis, and the said judge is authorized 
to make all necessary orders to carry into effect this power. 

TENNESSEE. 

That section 5488 of the code of Tennessee be so amended 
as to read, whenever the physician reports to the keeper of the 
penitentiary that any convict is insane, and ought on that 
account to be removed to the lunatic asylum, the keeper shall 
cause such insane convict to be removed accordingly, there to. 
remain until discharged by the physician of said lunatic 
asylum. 

TEXAS AND IOWA. 

If any person charged with, or convicted of any criminal 
offence be found to be insane in the court before which he is 



73 



so charged or convicted, said court shall order him to be con- 
veyed to and retained in the State Lunatic Asylum, and he 
shall be received and retained, until removed by the order of 
the court by which he was commit ed to the asylum. 

If any person after being convicted of any crime or mis- 
demeanor, and before the execution in whole or part of the 
sentence of the court, becomes insane, it shall be the duty of 
the Governor of the State to inquire into the facts, and he may 
pardon such lunatic or commute or suspend for the time being 
the execution, in such manner and for such a period, as he 
may think proper, and may by his warrant to the Sheriff of 
the proper county, or Warden of the Iowa penitentiary, order 
such lunatic to be conveyed to the hospital and there kept 
until restored to reason. 



As before said, the State of New York has made provision 
for the care in hospitals of all her insane poor. For this she 
is to be commended ; in this to be imitated. But the hospital 
or asylum referred to in the foregoing statutes, as that to 
which " insane convicts " and others are to be sent, is a luna- 
tic asylum established by a statute of 1858, 

ON THE PEISON GBOUNDS 

at Auburn, expressly for this object. In this, her purpose is most 
laudable ; but the propriety of her course is most questionable, 
as will more fully appear in the sequel. 

This Board had the honor, last year, of causing to be pre- 
pared and laid before the Senate, the draught of a bill " to 
provide for the care and keeping of the criminal insane of this 
commonwealth, — including those who may be acquitted of 
crime on the ground of insanity." And the proposition was, 
in general terms, that a department, a wing or a distinct 
building surrounded by a wall, of the hospital now under 
construction at Danville, should be so planned, arranged, 
completed and organized as to make it fit, suitable and con- 
venient for the care, keeping and treatm ent of the classes of 



74 



insane persons referred to. It may be proper to say that 
the Board had 

CHIEFLY IN VIEW, THE MORE NUMEROUS CLASS ; 

those who were in prisons with criminals, without ever hav- 
ing been convicted of crime ; and that they made their 
recommendation, so far as regards the less numerous class, 
the strictly "convict insane," on the assumption, which 
we have shown may fairly be made, that the vast ma- 
jority of such convicts were really insane, or, at least, in the 
incipient or latent stages of insanity, at the time the acts 
charged against them as crimes, were committed.* They 
were cases of this sort, or this was the aspect of the cases we 
had in mind, and for which we sought relief ; the others, the 
ten per cent, or so, we regarded as simply exceptions, which, 
at all events, should not vitiate the rule. We proposed but 
did not urge the bill ; and, through misunderstanding, and in 
consequence of opposition from interested parties, it was lost. 

At the late meeting in Baltimore of the Association of 
Medical Superintendents of Hospitals for the Insane, it was 
openly stated by a member from Pennsylvania that "that 
measure was defeated (I suppose) by the efforts of certain 
members of this association," and the statement was not con- 
tradicted. (See Journal of Insanity, Oct. 1873, page 236.) 

This meeting of medical superintendents was a notable one. 

* Report in relation to the insane convicts in the Eastern Penitentiary on February 24, 
1873, by Edward Townsend, Warden — number this date, 12. 
W. W. Confirmed lunatic on admission. 
M. L. Imbecile in mind on admission. 
T. R. Unsound mind on admission. 
A. N. Unsound mind on admisson. 
I. B. H. Imbecile on admission. 
G. V. Decidedly imbecile wben admitted. 
M. V. B. S. Very weak-minded on admiseion, since insane. 
Dora S. Insane on admission and remains so. 

Mary S. Insane on admission and had been an inmate of an insane asylum. 
M. McG. Very feeble-minded on admission. 
E L. Weak-minded, bordering on lunacy, when admitted. 
P. L. Insane on admission. 



Report of Edward S. Wright, Warden of Western Penitentiary, on the same subject, 
made at the same time. Number of insane convicts in Penitentiary, 8. 
Prisoner No. 3324, mental health, impaired on admission. 
ii 37 2 0) 

" 37.00, " " " 

" 3958, " " u 

ii ,« 400gj .< ii i< 

,< 400g) 

" " 4019, " insane on admission. 

" " 4030, " insane on admission. 



75 



Believing that the case of the proposed law just referred to, 
had not been fully understood, and wishing to have the subject 
freely and thoroughly ventilated, we addressed to the Presi- 
dent of this association, the following communication : 

Philadelphia, May 28th, 1873. 
11 Dr. J. S. Butler, 
"President of Convention of Medical Superintendents for the Insane. 

" Dear sir, — The morning papers inform me that the impor- 
tant humanitarian body over which you preside, has as- 
sembled for the consideration of the interests of the insane 
in convention at Baltimore. On other like occasions, the 
commissioners of this board have been honored with an invi- 
tation, — to be represented, of course, in presence merely ; but 
still we are glad to be apprised of your meeting by public 
announcement, and venture to address you on a subject of 
great interest to this Board, and one which, we think, has 
escaped any authoritative action of your body. 

" We refer to the subject of the care of the ' criminal in- 
sane.' TVe are led to refer this matter to you for action, be- 
cause of an unsuccessful effort made by this Board to have a 
precedent established by the Legislature of the State of Penn- 
sylvania, to construct a department for this class upon the 
grounds of the Hospital for the Insane at Danville, Pen?ia.. 
for the reception and treatment of (for the most part) the 
irresponsible insane, wh o are now incarcerated in the peniten- 
tiaries and jails of this Commonwealth. 

"It is true that we did not press this matter upon the Legis- 
lature, believing that the simple proposition should be suffi- 
cient for favorable action ; but as the higher advice of repre- 
sentatives from this State in your Convention prevailed to 
defeat the measure which we proposed, we feel justified in 
asking you to take such definite action as will have like influ- 
ence in protecting the class, who are committed, in this State. 
at least, (I am glad to say not in all other States) to the mis- 
eries of a felon's doom. 

" In noticing this subject I beg your permission to venture 



ll> 



on a few observations on the subject, and in doing so I ex- 
press the mind of every member of this Board. 

•• It is a fact patent to all of us, that multitudes of irrespon- 
sible criminal insane are now in the prisons of many of the 
States, and it is equally true that the influence of the body 
known as the Association of Medical Superintendents of 
American Institutions for the Insane, has exercised a most 
potent and salutary influence, in shaping the legislation of 
the several States, in behalf of this afflicted class of their 
citizens. 

" Believing that your influence will avail to check the enor- 
mous wrong which the class we refer to suffer, we ask your 
intervention in their behalf, and urge you to set forth a dis- 
tinct and definite policy which shall satisfy its demands. 

"We know that in Great Britain there are two asylums for 
the specially criminal insane ; one at Broadmoor, not far from 
London, a distinct institution with accommodations for from 
live to six hundred inmates ; and one at Perth, Scotland, 
under penal jurisdisdiction, but in charge of a special super- 
intendent. 

" We know that on the continent of Europe there is no special 
provision for the criminal insane ; it being held by the most 
distinguished alienist physicians and so proclaimed in many 
works on psychological subjects, that insanity should level all 
distinctions ; and, as Dr. Manning reports, that 'the great gulf 
which separates the convict from the honest man is bridged 
over by insanity ; that when sick in body, the prisoner should 
be kept within his prison and treated for his malady, but 
when sick in mind, the prison should be opened and the badge 
of the convict be forgotten." 

" In this view, the well known humanitarian, Miss Dix, 
concurred. 

•• We also know that in these United States there is an asy- 
lum for insane convicts at Auburn, Xew York, intended 
originally for the reception of such as became insane when 
convicts but more recently for those,, also, who have been 
acquitted on the ground of insanity. We know of no other 



77 



special provision made for this class, unless it be in jails. 
In the State of Pennsylvania there are no t, we think, over 
ten per cent, of the number who are now confined in the 
penitentiaries and jails, who, on the report of the wardens and 
prison-keepers, were not insane when sentenced, and of this 
small percentage, some, of course, were mentally imbecile or, 
in the incipient stage of insanity, when the crime was com- 
mitted. The law holds them to be ' irresponsible,' and, still, 
they are held as felons by the act of the law. As has been 
well said ' the courts fail to detect the disability for want of 
a proper defence or because the mental disease is still latent.' 
The jails thus receive these forlorn ' wards of the State' 
forsaken by man, not, we believe, by God. We could 
enumerate instances of marked cruelty in individual cases, 
but we point only to the injustice which must inevitably 
oppress them, when subjected to the treatment of prisoners 
in the State and county jails : Their lightest affliction being 
perpetual incarceration within the limits of a cell, without the 
slightest consideration of their sufferings or their needs. 
This is the case, certainly, in Pennsylvania. 

"There will be no dispute as to the impolicy as well 
as the wrong-doing of such ' proceedings.' These 'irre- 
sponsible' citizens are, as is often said, 'wards of the State.' 
Surely no official of the State, no private citizen, who is the 
head of a family, would overlook the claims of his own chil- 
dren. They would extend the solace and the help all the more 
for their infirmities. 

"In the year 1871 the Massachusetts Board of Public 
Charities addressed communications to the Superintendents 
of the lunatic hospitals of that State, requesting their views 
on certain points. That which concerns this Board is the in- 
quiry as to the provision which should be made for the class 
to whom we refer. It is highly honorable, in our judgment, 
to the intelligence as well as to the humanity of each of these 
distinguished gentlemen, that neither recommended that a 
hospital for the ' criminal insane ' should be an appendage or 
an appurtenance of a prison, or built at all on prison grounds. 



78 



On the contrary, although one of them, to relieve the urgency 
of the case, admits that he has recommended the fitting up 
of a lunatic ward in the State Prison, to be placed under the 
special care of the prison physician, still he declares, ' there 
would be but little objection, aside from sentiment, to the 
treatment of lunatic convicts in a properly constructed hos- 
pital for the insane, where they would not mingle indis- 
criminately with the other classes of patients.' Another 
says, ' I would not advocate making it an adjunct of the State 
Prison, or any penal institution.' The last, after recommending- 
that a distinct institution "be established for the reception of 
this class, says, with the knowledge that they are provided for r . 
[in Mass.] in the State lunatic hospitals, 'if the Superinten- 
dent and Trustees of any State lunatic hospital, and the* 
general agent of the Board of State Charities, concur in the 
opinion that a patient of said hospital ought to be removed 
to said building, he should be so removed. This is the alter- 
native to care and treatment in a general hospital for the 
insane: in Pennsylvania, [it would be] from a prison to a 
hospital. 

" As the result of the investigations of this intelligent 
Commission, and the views forcibly presented by the eminent 
alienist physicians of their own State, viz., Drs. Godding, 
Earle, and Bemis, this cautious Board has recommended in 
their present report, just issued, the establishment of a hospital 
for the ''criminal insane? to be placed near enough one of the 
other State hospitals for the insane to be under the same ad- 
ministration. 

" This Board concurs in the principle which underlies this 
recommendation, as well as in its practical wisdom; for, as to 
the latter, it cannot be expected that any one State will incur the 
expense of an independent establishment for this class and 
the cost of its proper oversight and maintenance. As has 
been already stated, there is but one in England whose 
population approximates to our own, [that of the United 
States.] As to the former, there is no moral ground upon 



79 



which the separation of the two classes can be based. It is 
simply the ground of disagreeableness, to those who conduct 
the institution, to a small proportion of the patients, and to 
some of their friends. It is ' sentiment ;' and this we admit 
should be religiously regard ed in the consideration of every 
provision for the insane. Let it not be overlooked in behalf 
of the class we are now considering! We say sentiment only, 
for the scheme proposed to our Legislature provided for a 
separate and secure building, separately enclosed with suit- 
able walls, but to be under the supervision of the Superintendent 
of the General Hospital, on the same premises." 

"Believing that our views have been clearly conveyed in 
this communication, and excusing its crudeness, by the 
obvious necessity of haste, I beg most respectfully to com- 
mit the subject to your thoughtful determination and action; 
and I trust that they may be so enlightened, as to reflect 
honor upon your body and yourselves individualy — not 
merely for the present, but for all time. 

" I am most respectfully yours, 

" GEO. L. HAKRISON, 

" President." 



When the association entered upon the consideration of 
this letter, the following resolutions were offered : 

" Whereas, The proper disposal of that class of the in- 
sane, whose criminal acts require their seclusion and confine- 
ment, is a matter on which this association is requested to 
express an opinion, 

"1. Resolved, Therefore, as the opinion of this association, 
that neither jails and penitentiaries, nor ordinary hospitals 
for the insane are proper receptacles for this class of persons ; 
but that they should be cared for in establishments designed 
expressly and solely for them. 

"2. Resolved, That under no circunstances should 'insane 
convicts' be associated with other insane persons, believing 



80 



that such an association is not calculated to improve the con- 
dition of the latter, and that the best interests of the former 
require a special manage ment, and architectural arrangements 
of a peculiar kind, both very different from such as are 
adapted to the needs of other classes of the insane. 

" 3. Resolved, also, that the example of the State of New 
York, which has thus provided for its 'criminal insane,' as 
they are usually called, be commended to imitation by other 
States, either singly or collectively." 

We take the liberty of reproducing here some of the most 
note- worthy utterances which this discussion called forth in 
the association, as they are published in the jonrnal of in- 
sanity, before cited. 

Dr. Shew, Superintendent of the General Hospital for the 
Insane, Middletown, Conn., " If the resolutions refer to per- 
sons who commit acts which would be considered criminal 
were they not insane, I cannot concur in all the resolutions. 
Many of the patients received in our hospital commit those 
acts, and are sent to the hospital because they are dangerous 
to society; — dangerous as insane persons. It seems to me that 
there can be but one opinion, and that is that insane criminals 
should be separated entirely from patients in hospitals. First, 
because of the dangerous influence upon other patients ; 
secondly, because of the odium which it brings on the insti- 
tution, and the unpleasant feeling which the friends of the 
patients have in supposing or believing, that their loved - 
ones are associating daily and hourly with criminal persons." 

"In practical experience I have not found that 'insane 
convicts' are particularly objectionable in themselves — not so 
much as Dr. Shurtleff and Dr. Curwen have." [Dr. Curwen 
has not given his remarks in the official publication.] "Three 
years ago the Legislature of Conne cticut passed a law requir- 
ing the Trustees of the Hospital at Middletown to receive all 
insane convicts after a proper examination, which was 
specified, and a commission appointed. We had no separate 



81 



provision, and were obliged to receive them in the hospital 
proper, 

AND PLACE THEM IN ASSOCIATION 

with the other patients. Since that time twelve insane con- 
victs have been transferred from TVethersfleld to Middletown ; 
two of that number have escaped; one of them feigned in- 
sanity ; arrangements had been made to transfer him to \Yeth- 
ersfield, but he escaped the very night before the transfer was 
to be made. Of the ten others, seven have been among the 
most valuable farm laborers, harmless, industrious and 
peaceable, and yet positively insane; much less dangerous 
than many of the chronic patients. One of the number has 
been very valuable the past few years, in sharpening the 
tools used by the stone-cutters in the erection of the two 
wings, saving the cost of one skilled mechanic. It was his 
trade and occupation, before being sent to prison. 

NONE OF THE SEVEN WHO HAVE BEEN EMPLOYED EVER 
ATTEMPTED TO ESCAPE." 

[ Why then was it, that in the case of the eight insane convicts 
sent to the Harrisburg Institution, five managed to escape?] 

" They are generally liked by the patients, and are not more 
troublesome than others. The friends of the patients [' pay- 
ing' patients, doubtless] object to the association, and in my 
report last year, I called the attention of the Legislature to 
that fact, and asked that an appropriation be made for a sep- 
arate building, distinct from the main hospital, a cottage sim- 
ply, to provide for the insane convicts. * * * * During the 
present year, we hope to have a building for the accommoda- 
tion of twenty persons, in which we will provide for all the in- 
sane convicts. There have been only three transferred from 
\Yethersneld each year." 

Dr. Shew, then, assuming that the population and re- 
sources of some of the States, and the number of their in- 
sane convicts, may be such as to warrant the construction in 
each, of an entirely separate hospital for their accommoda- 
tion, with all the best appointments for their proper care 

[6] 



82 



and treatment, — proceeds to express, in that case, his prefer- 
ence for having such a hospital, intended exclusively for the 
insane convicts proper, erected on the grounds of the State 
Prison, rather than on those of a general hospital; but 
otherwise, and for other States, he clearly prefers such an 
arrangement as he has described at Middletown. 
Dr. Compton of Mississippi : — 

II The third resolution I think I would amend, because that 
condemns the action of my own State in this matter. It de- 
clares that under no circumstances should insane convicts be 
permitted to associate with other insane persons, believing 
that such association is not calculated to 'benefit the insane, 
&c. I would be very decidedly against the first part of the 
resolution, that, ' under no circumstances should they be 
associated.' I would take them into my asylum, rather than let 
them remain in the penitentiary or jail. In the absence of the 
proper provisions, I would take them out of the penitentiary and 
jails, and put them into my asylum." 

Dr. Earle, of Northampton, Mass. : 

II I would put the convict insane in a separate institution, 
independent of all other institutions. 

I WOULD PUT IN THE SAME PLACE, 

those who have been tried for crime and acquitted on the 
ground of insanity ; then those incendiary and homicidal 
patients, who never had been tried for crime. I would make 
the provision that they should be removed to that institu- 
tion, but not unless it was decided by the Superintendent of 
the hospital, and the Board of State Charities and its agents ;■ 
all these authorities must concur before a man who had com- 
mitted a criminal act, and had not been convicted of crime, 
should be removed [not from the common hospital to t"he 
penitentiary or prison, but] from the common hospital to 
this institution. This applied only to the incendiary and 
homicidal class, because 

OUR MOST DANGEROUS PATIENTS ARE NOT CONVICTS, 

and have never been tried for crime and acquitted on the 
ground of insanity." 



83 



Dr. Gundry, of Athens, Ohio : 

" In endorsing the action of the State of New York, we go 
further than my amendment would contemplate, because we 
endorse this course. They have done very well in providing 
a hospital for insane convicts, but with those insane convicts 
they send persons who are compelled to mingle with them, 
whose acts of violence were committed in their diseased con- 
dition. It is urged that this is a matter of expediency, be- 
cause the hospitals are not able to contain them for various 
reasons. 

IF THE HOSPITALS ARE NOT PKOPERLY CONSTRUCTED MAKE 

THEM SO. 

" If special arrangement are required for violent patients, 
have those special arrangements made." The doctor then 
goes on to speak with more kindness than respect, of Boards 
of State Charities, but with this we have nothing to do. 

Dr. Smith, of Fulton, Missouri: — 

" I must also object to that part of one of the resolutions, 
which endorses the New York law. Those conversant with 
this law inform us that one of its provisions requires that 
all acquitted on the ground of insanity, shall, in the discre- 
tion of the judge, be sent to the same institution designed 
for convicts." [And, he might have added, standing as a de- 
partment of the State Prison.] " Such a provision as this I 
cannot endorse. * * * Endorsing this law would be equiva- 
lent to endorsing the punishment of the insane, because of the 
acquittal of crime ; the penalty of assigning them to a position 
most repulsive to their feelings and those of their friends, 
and one that would not only retard but often prevent re- 
covery". [What would the Doctor have said of sending 
them, as we do, not to a common hospital, but to a common 
prison ?] " We have patients in our institution, who, prior to ad- 
mission, committed terrible deeds, and, no doubt, there are such in 
most hospitals for the insane. We have fathers who killed 
their wives and children ; and a mother who killed her hus- 
band, all under the influence of delusions in regard to differ- 



84 



ent members of their families. These patients have been as 
orderly, quiet and pleasant as any in our building ; have 
shown no tendency to violence, and exerted no injurious 
influence over others." 

The resolutions were amended and finally passed as fol- 
lows ; and were transmitted to us as the response of the 
Association. 

"Whereas, The President of the Board of Charities of 
Pennsylvania has requested that this Association should ex- 
press its opinion in regard to the proper disposition of insane 
convicts, therefore, 

"Resolved, 1. That neither the cells of penitentiaries and 
jails, nor the wards of ordinary hospitals for the insane are 
proper places for the custody and treatment of this class of 
the insane. 

" 2. That when the number of this class in any State (or 
in any two or more adjoining States which will unite in the 
project) is sufficient to justify such a course, these cases 
should be placed in a hospital specially provided for the pur- 
pose : and that until this can be done, they should be treated 
in a hospital connected with some prison, and not in the 
wards nor in separate buildings, upon any part of the grounds 
of an ordinary hospital for the insane." 

The published report of the debate, from which we have 
made the foregoing citations, as containing important medi- 
cal opinions bearing on the subject in hand, would have been 
more complete and fair, as well as less liable to misunder- 
standing, if the letter from this Board, which called it forth, 
had not been suppressed. It would then have appeared that 
both the debate and the final action of the Association failed 
to grasp the precise points presented in the'letter. They 
treated the subject with reference to an ideal standard, rather 
than with reference to the actual laws and practice of Penn- 
sylvania in the case. 

The whole debate and the final action were eventually 
narrowed down to the case of " insane convicts " exclusively, 



85 



instead of taking into view all the classes of the " criminal 
insane," so called, which were presented for their considera- 
tion. 

It is instructive, however, to compare the resolutions 
finally adopted with those originally proposed. 

1. Both sets of resolutions agree, — and so did, apparently 
every member of the Association, in the most emphatic 
manner — in the fundamental principle, that neither the cells 
of jails and penitentiaries, nor the wards of ordinary hospitals 
for the insane, are proper receptacles for the custody and treat- 
ment of that class of the insane, whose case was under con- 
sideration. 

2. The resolutions adopted confine themselves to the care 
of 

INSANE CONVICTS AS SUCH, 

a portion only of the cases submitted for consideration, while 
the original preamble included the "proper disposal of that 
class of the insane, whose criminal acts require their seclu- 
sion and confinement." Precisely what class was intended 
to be thus described, might be doubted, but if simply 
"insane convicts" were intended, it was a very circuitous 
way of saying so. 

3. It is not expressly and positively declared, in these, as 
in the former resolutions, that, under no circumstances, should 
" insane convicts " be associated with other insane persons ; 
but merely that they should be treated 



It is left an open question whether or not other special 
classes of insane persons may be treated in the same specially 
provided hospital, i. e. supposing such hospital not to be on 
prison grounds, and at the same time not a department of 
any ordinary hospital for the insane. 

■i. The commendation of the Xew York plan, of sending 
other insane persons besides convicts to a hospital connected 
with a State prison, is carefully avoided. 



5. A separate hospital for this class, — separate from pri- 
sons as well as ordinary hospitals, — is proposed as the pro- 
per and desirable plan — provided it can be had. 

6. Until such a hospital can be had, it is proposed, as an 
imperfect, temporary and unsatisfactory substitute, — but 
as much better than giving "insane convicts" no special or 
remedial treatment at all, that they, i. e. 



should be treated in a hospital connected with some prison, 
rather than on the grounds of any " ordinary " hospital for 
the insane. 

The conclusions thus reached, as far as they go, would be 
quite in harmony with the views of this Board, except, per- 
haps, in the last-mentioned particular ; and, on that point, 
there might be no substantial disagreement, when the case is 
narrowed down to the precise circumstances contemplated, 
and the precise expressions employed. It is, in terms, an un- 
desirable alternative, which is thus presented. We think, and 
we shall hope to show that it is 

NEITHER REASONABLE NOR NECESSARY TO RESORT TO 
SUCH AN ALTERNATIVE AT ALL. 

The plan of two or more States joining in the erection or 
support of a hospital for insane convicts is not new. Such 
a plan was proposed and drawn out at large by Dr. Edward 
Jarvis of Massachusetts, in 1857, in a very able and sugges- 
tive paper on the "criminal insane." We cannot but regard 
all such propositions as simply futile. 

NO TWO OR MORE STATES WILL EVER COMBINE 

in building a common hospital for their "insane convicts;" 
nor will any one State ever provide such a hospital for the 
use of other States. In reference to such joint action, the 
case of insane convicts is very different from that of the 



87 



blind or deaf mutes or the ordinary insane. We may there- 
fore dismiss such suggestions as visionary and illusory : And 
the fact that United States convicts are received into the con- 
vict prisons of several of the States, in the absence of a na- 
tional prison, furnishes no parallel at all to the expedient 
suggested, of one State taking charge of another State's con- 
victs. It may be quite possible, and fair, also, for a child to 
accommodate a parent in an emergency; and impracticable 
and unreasonable to extend like assistance to a fellow child. 
But let it be observed in any case, that we make no objection 
to the joint action of several States in the premises; we only 
express a decided opinion that it will never be brought 
about. 

It remains, then, for each State, to make provision for her- 
self. We must consider the subject in this point of view, if 
we are to give it any practical consideration at all. Now no 
one State, — not even New York or Pennsylvania, has such a 
number of insane convicts, in the strict sense of the terms, as 
would warrant- the erection and equipment of a completely 
separate hospital for their exclusive care and treatment: 
Such a hospital as should furnish them the best supervision 
and attendance — and nothing less ought to be furnished 
them. The number of such convicts in this State is proba- 
bly not many more at any one time, than could be accommo- 
dated in Dr. Shew's "little cottage" attached to his hospital. 
For it is to be observed that the magnitude of the existing 
evil in this particular case, consists not so much in its nu- 
merical extent, as 

IN THE PRINCIPLE INVOLVED, AND IN ITS RAMIFYING 
CONNECTIONS. 

The State has no right to offset economy against an in- 
justice or against inhumanity; but she has a right, in doing 
justice, to study economy; and she is likely more fully to 
meet the demands of justice and humanity on the whole 
and in the long run, when she makes her plans with a far- 



88 

seeing and systematic economy, than when she indulges in 
spasmodic extravagance. 
It may be assumed as another settled thing, that 

THE STATE WILL NEVER ESTABLISH AN ENTIRELY 
SEPARATE HOSPITAL, 

separate from all connection either with prisons or with ordi- 
nary hospitals, 

FOR THE EXCLUSIVE ACCOMMODATION OF TWENTY OR 
THIRTY "INSANE CONVICTS;" 

and provide it with all the appointments of a complete hos- 
pital for the care and treatment of the insane. This plan 
may be dismissed as equally visionary and illusory with the 
other. 

But it is not to be forgotten that, besides the strictly insane 
convicts, there are other analogous and closely bordering 
classes of insane persons yet to be provided for in this 
State: (1) Those who have been convicted of crime, but 
have served out their sentences and continue insane ; and of 
these, there may be nearly as many as of the others. (2) 
Those who have been charged with crime, but are found in- 
sane before trial or sentence; — these are a class nearly as nu- 
merous, probably, as the insane convicts, and yet they are 
not insane convicts. (3) Those who have committed terrible 
acts of violence or destruction, as homicide, arson, burglary 
&c, and have been acquitted of crime on the ground of in- 
sanity; but, who, for the safety of the community, must be 
kept under the most watchful and perhaps rigorous restraint, 
as well as provided with the most skillful curative treatment. 

ALL THESE CLASSES ARE NOW IN OUR JAILS AND 
PENITENTIARIES OR POORHOUSES, 

or are by law liable to be there, and other classes beside 
them ;* and their case is to be provided for as well as that 

*The following facts are reported by the General Agent of this Board, under date : Nov. 1 
Insane frequently sent into prison, sometimes as many as eight or ten at a time, who aie 
kept until the court decides what disposition to mako of them. 
One lunatic sentenced Nov. 13th, 1868, for ten days, to enter bail for good behavior. In 









89 



of the strictly insane convicts. And even if a special hos- 
pital should be provided for insane convicts, in connection 
with some prison or penitentiary and on the prison ground, 
rather than in connection with one of the State Lunatic 
Asylums, and with the imperfect appointments and supervi- 
sion which must needs characterize such an establishment, 
considered as a mere department of the prison ; we will not 
ask noAV whether this is all that is due to the "insane con- 
victs" themselves, but we do ask whether those other classes 
of insane persons ought to be 

SEXT TO SUCH A HOSPITAL, TO ASSOCIATE WITH THE INSANE 
COXVICTS IX A DEPARTMENT OF A PRISOX ? 

Either that, or left in the cells of the jails and penitentiaries, 
or poorhouses, where they are. But it is asked, why not send 
them, in such a case, to the ordinary lunatic hospitals ? We- 
answer by asking why they are not uniformly sent there 
now ? or, why, when sent there, they are exposed to be re- 
manded to the prison cells ? 

It may be said that this very class of "criminal insane" 
are in the hospitals, and that the "returns"' to this Board 
from these institutions present this fact continually. We 
have not denied or disputed the fact. We have not found 
fault with the little good that is done ; but only with the 
great wrong-doing which so completely obscures and over- 
shadows it. The law should declare the rights of every citi- 
zen, and vindicate them uniformly and without exception, 
especially the rights of the poor and defenceless. 

In fact the whole question is narrowed down to these 
points : 

default of bail he has been confined ever since. The cause of his detention is the want of 
suitable accommodations in the County Almshouse. 

Eight insane were sent to this prison in 1S72, all of whom were transferred to the County 
Almsh .mse. 

One lunatic confined since last winter, was sent here from the poorhouse for safety, not 
being able to keep her at the latter. 

One "criminal insane" confined nearly six years under a " charge" of arson. 

One man charged with having stolen a horse, was acquitted on the ground of insanity, 
but is still confined. 

One committed for threat to kill. 

One man not charged with crime, committed for safe-keeping. 

Insane frequently committed. 

One charged with attempt to shoot, suffers under mental disorder. 

Insane frequently committed. 



90 



1. It is agreed on all hands that neither prisons nor ordin- 
ary hospitals, with the ordinary arrangements, are fit places 
for the custody and treatment of " insane convicts." 

2. The co-operation of several States in establishing or 
maintaining a special hospital for that purpose, is out of the 
question. 

3. It is equally out of the question for one State, for this 
State, to provide for the exclusive use of this class of insane, 
an entirely separate institution, with the proper hospital 
equipment and superintendence. 

4. Their special hospital, therefore, if they are to have 
any, must either be upon the grounds of a prison and an 
appendage to it, with the imperiect and insufficient supervi- 
sion of the prison physician, the attendance of* prison over- 
seers or keepers, and the atmosphere of prison associations, 
or 

UPON THE GROUNDS OF SOME STATE HOSPITAL, 

so as to be under the same supervision of high and appro- 
priate medical character, the same attendance and the same 
curative influences; though, while a department of the hos- 
pita], it may be made as completely secure and kept as sepa- 
rate from it as may be thought best, — to be denominated not 
" the convict department" or " the criminal department," but 
simply " the special department of such a hospital." This 
remains 

THE ONLY PRACTICAL ALTERNATIVE. 

If the former course is chosen, the patients will not be 
secured that degree of skillful treatment and of humane and care- 
ful attendance, which is their due, and without which there is 
small prospect of their recovery ; and, what is perhaps more, 
it would be 

UTTERLY UNJUST AND OUTRAGEOUS TO RETAIN THOSE OTHER 
CLASSES OF THE INSANE, — 

if placed in the same hospital with the convicts,— not only 
in connection with those convicts, but in association with 



91 



the scenes and the character and the odium of the peniten- 
tiary. Even that might, indeed, be an improvement upon 
their present condition ; but in principle and in fact the 
wrong inflicted upon them would be the same ; they would 
still be 

CONSIGNED TO THE PENITENTIARY. 

Either this, we say again, or they must be sent to ordinary 
hospitals. 

If, on the other hand, the latter alternative is chosen, then 
this special or separate department of the hospital, instead of being 
regarded as properly intended for insane convicts, may and should 
be regarded as intended chiefly and in the first instance, for the 
accommodation and safe-keeping of the three, and perhaps 
other, classes of insane persons above described; and the far 
less numerous class of insane convicts may be regarded as 
being admitted, in the character of insane, to a higher position 
than, as convicts, they could claim; and, meantime, the 
infamy of incarcerating innocent and helpless men and 
women in the criminal's dungeon would be done away, 
while the ordinary hospitals would be relieved from the 
charge of some of the insane, who require the most 
special and expensive arrangements for their safe-keeping. 
It would not be that the insane of these other classes would be 
thrust into a convict hospital ; but convicts would be admitted to 
a hospital intended for other classes. And even this need not con- 
tinue, and should continue no longer than till the State should 
feel justified in establishing a totally separate hospital for the 
insane convicts themselves. If, till then, it be thought a wrong 
to these other classes of lunatics, that convicts, though in- 
sane, like themselves and equally irresponsible, should be 
thrust upon their society at all, we answer that among 
these classes as little of actual association or intercourse 
might be allowed, even within this separate department or 
wing of the hospital, which they would occupy in common, 
as might be thought advisable. At all events, to be obliged 



92 



to be associated with insane convicts in a common hospital is 
small ground for complaint, in comparison to being thrust into 
association with felons, sane as well as insane, in a common 
prison. As to the inmates of the other departments of the 
general hospital, on whose grounds this special and separate 
department would stand, for us or for their friends to think 
of any hardship or degradation to them in consequence of 
their separate connection with this department, is, surely, nothing 
less than the most superlative extravagance of sentimental 
fastidiousness ; especially when it is remembered that the 
whole hospital is furnished by the liberality of the State for the 

ACCOMMODATION OF POOR AND DESTITUTE INSANE PEOPLE; 

people, too, who would, otherwise, be miserably and hope- 
lessly languishing in poorhouses and prisons. 

And, besides, the objection to making the provision we have 
suggested for the criminal insane, so called, in a separate de- 
partment on hospital grounds, leaves only the alternative of 
keeping them in direct association with unoffending insane in 
the poorhouses, where they are constantly sent ; so that, as 
these are not "paying" patients, it would seem that they are 
to be left out in a discussion of the subject, and their rights 
are not to be considered. Let us not continue, as a State, to 
inflict, by the wholesale, upon our helpless fellow creatures 
the most outrageous wrongs, until we can be sure of doing 
right with the most mathematical precision, or 

AFTER THE NICEST AND MOST PERFECT IDEAL AND SENTI- 
MENTAL MODEL. 

Let us not strain out the gnat, while we unhesitatingly 
swallow the camel ! 

The suggestion, that in dealing with insane convicts, one 
of two things must occur, namely, that, "you must make a 
prison of the hospital or a hospital of the prison " — and that 
the latter alternative is wiser and more humane, is, we con- 
sider, more specious than sound. We think, we have shown 
that the tendency of the prevailing system in this State is to 



93 



" imprison " numbers of irresponsible insane, whose clear 
right it is to enjoy " hospital " care. Surely this should be 
reversed even, if need be, at the inconvenience, (if it be such) 
to the hospital of caring for a few individuals who have 
been guilty of crime, and have since become insane. 

One of the strangest and most inhuman suggestions in 
Tegard to the insanity of convicts, is, that it should be con- 
sidered as " a part of their punishment." So far as their 
whole punishment is to be regarded as a divine infliction, 
the suggestion is entirely true, and God's ways can un- 
doubtedly be vindicated ; but, from this point of view, the 
same is true of all cases of insanity : they are all visitations 
of Divine Providence, and, as such, are just and not to be 
murmured against. However great the suffering, it is, in 
every case, a righteous infliction. But to say that insanity 
is any part of the punishment inflicted on convicts by the 
sentence of human law, is simply false. If it were true ; if, 
by the sentence of the law, men were to be driven insane, as 
a punishment for their crimes, — some, and not others ; without 
any " rhyme or reason " in making the distinction, — it would 
be nothing short of the grossest and most detestable inhu- 
manity as well as injustice. In the case of convicts, in- 
sanity is no more a part of their punishment, than any other 
disease. If a convict is seized with fever or small-pox, shall 
we say "it is a part of his punishment," and so leave him to 
its consequences ? No, we are to give him such diet and 
care and medical treatment as will be likely to ensure Ms re- 
covery in the shortest time. This can be done in the prison 
hospital. All we ask, is, that the same be done in case the 
disease is insanity. If this can be done, — if the best medical 
superintendence and care can be provided in connection with 
the prison, let it be done; we have no objection to make. 
But if not, if better provision can be supplied for these pur- 
poses, in connection with some established hospital, and at 
vastly less cost, then let this latter course be preferred and 
adopted. 

The whole matter is narrowed to a question of expediency 



94 



and expense. If the State is prepared to meet the expense 
of providing the appointments of a first-class hospital, ex- 
pressly and exclusively for twenty or thirty "insane con- 
victs;" very well, let them be forthwith provided. But, if 
not, let some other adequate provision be made. At all 
events, let not helpless lunatics be left incarcerated in the cells of 
prisons and poorhouses. 

We have said before, and we now say again, that neither 
insanity nor the privation of proper treatment in case of 
insanity, is any part of the sentence imposed upon convicts 
by law ; and if there are still any who maintain that insan- 
ity is to be regarded as " a part of the convict's punishment," 
we beg only to add that such views as these are not shared in 
by the distinguished medical gentlemen, nor by the eminent 
philanthropic citizens, who have intelligently, and with full 
knowledge of the import of what they have done, set their 
hands to the accompanying 

MBMOEIALS 

to the Legislature, praying your honorable bodies to redress 
the wrongs not merely or chiefly of insane convicts, but of 
the several classes of insane poor, upon whose defence we 
have entered, against not only the injurious insinuations of 
interested parties, but the actual personal injuries and suffer- 
ings, which are continuously heaped upon them, in defiance 
of every impulse .of humanity, as well as every sober and 
righteous conviction of reason and judgment. 

To the Board of Public Charities of the State of 
Pennsylvania. 

The undersigned, practising physicians of the cities of 
Pittsburg and Allegheny, request your Board to take action 
looking to the repeal or modification of some of the provisions 
of law in relation to the treatment of the insane, more es- 
pecially of those who have been acquitted on the ground of 
insanity, or who have ^become insane while incarcerated in 
prison or penitentiary. 



95 



We understand that the laws of this State in reference to 
these unfortunates are such, that in some cases, the courts 
are expressly forbidden to commit them to the hospitals un- 
less they are deemed speedily curable ; and that in cases where 
insane criminals or persons acquitted on the ground of in- 
sanity, have been sent by the court to the hospital, the 
Board of Managers and Superintendent or physician, if they 
deem them incurable, may send them back to the jail or 
penitentiary from which they came. 

"We are assured that such treatment of the insane, whether 
criminals or not, is inhuman ; and knowing as we do that a 
prison or penitentiary is not, and cannot be a fitting place for 
the treatment of human beings so sadly afflicted, whether in- 
curable or not, we earnestly appeal to you, and through you, 
to the Legislature of our State to have such a change made 
in the laws as will effectually prevent the exposure of the 
insane of any class, to incarceration in our prisons, jails, or 
penitentiaries. 

Yours, &c, 

Andrew Fleming, M. D. A. M. Pollock, M. D. 

Geo. D. Bruce, M. D. W. C. Eeiter, M. D. 

H. T. Coffey, M. D. Julian Bogers, M. D. 

F. Le Moyne, M. D. R. B. Mowby, M. D. 

W. J. Estep, M. D, C. B. King, M. D. 

J. N. Dickson, M. D. J. B. Murdoch, M. D. 

Thos. W. Shaw, M. D. W. R. Hamilton, M. D. 

John Dickson, M. D. Jas. King, M. D. 

A. W. McCoy, M. D. Jas. McCann, M. D. 

John S. Dickson, M. D. T. C. Rhoads, M. D. 

W. Snively, M. D. James Macfarlane, M. D. 

• Pittsburgh, December, 1873. 



To the Legislature of Pennsylvania, 

Philadelphia, December, 1873. 
The undersigned, members of the Medical Profession, 
being aware of the sad condition of the " poor " and the 



96 



c< criminal " insane, who are suffering cruel personal wrongs 
and constant deterioration of their mental and bodily condi- 
tion, in the jails and poorhouses of the State, respectfully 
appeal to your honorable bodies to provide such legislation, 
as will effectually secure the admission and detention of 
these classes in the State hospitals for the insane, so long as 
their malady requires it. 

We believe that both humanity and public policy demand 
such legislation for the relief of wrongful suffering, and for 
the restoration to health and usefulness, of these afflicted 
and injured classes. 

S. D. Gross, M.D. J. Forsyth Meigs, M.D. 

Joseph Pancoast, M.D. Edw. Hartshorne, M.D. 

Alfred Stille, M.D. Caspar Morris, M.D. 

Francis GL Smith, M.D. J. M. Dacosta, M.D. 

S. "Weir Mitchell, M.D. Hiram Corson, M.D. 

William Pepper, M.D. Horatio C. Wood, M.D. 

D. Hayes Agnew, M. D. John H. Packard, M. D. 
F. F.Maury, M.D. 



To the Senate and House of Eepresentatives of 
Pennsylvania: 

We gladly unite our names with those of the eminent 
jurists, the. distinguished physicians, the inspectors and war- 
dens of the penitentiaries, and other noted personages, familiar 
with the subject, in the appeal of the Board of Public Chari- 
ties to your honorable bodies, to redress, by proper legisla- 
tion, the wrongs of the " poor " and the " criminal " insane, 
who are now consigned to the jails and almshouses of the State; 
and who should, properly, be placed in the State Hospitals 



97 



for the insane, which were established by the public for their 
reception, their care and remedial treatment. 



James J. Barclay, 


TTm. Bacox Steyexs, 


Jos. E. Chandler, 


Jxo. TVelsh, 


Mahlox H. Dickinson, 


Caleb Cope, 


Henry C. Carey, 


Johx M. "Whitall, 


Isaac Lea, 


TVm. Bigler, 


Jxo. 0. James, 


Asa TVhitxey, 


James Thompson, 


M. SlMPSOX, 


late Chief Justice. 


Bishop. 


December 1, 1873. 


• 



After the fullest investigation of facts and the maturest 
reflection upon the case, we are constrained to declare that, 
in our clear conviction and judgment, every consideration of 
humanity, justice, propriety and expediency, is combined in 
favor of placing the special hospital for the "criminal in- 
sane," so called, including incidentally and temporarily " insane 
convicts" 

OX THE GROUXDS OF SOME STATE HOSPITAL, 

so as to be under a common superintendence therewith, 
rather than within the purlieus of any prison. 

TVe, therefore, most earnestly renew our recommendation 
that such a separate hospital department be speedily pro. 
vided, with the proper construction and arrangements for 
the purposes indicated, on the grounds of the Danville 
Hospital. 

We, further, feel constrained to suggest, — and we do it 
with much hesitation, and with sincere respect for all parties, 
— that, in forming a judgment on this scheme, a prepon- 
derating weight ought not to be attached to the opinions of 
parties, who may have any personal interest or convenience 
involved in the question, however respectable thev may be. 

[7] 



98 

and even though, they present themselves in the charac- 
ter of experts. 

THE AUTHORITY OF EXPERTS IS LIMITED 

to their particular professional sphere. Their proper office 
is to serve as witnesses and not as judges ; and any intelligent 
and disinterested layman, who by personal observation, and 
thorough study, has made himself acquainted with the 
condition of the insane in our penitentiaries, jails, poor- 
honses and hospitals, is as well (perhaps better) qualified to 
judge, as they are, of the broad features of any plan proposed 
for ameliorating their condition — to judge what is consistent 
with or demanded by the dictates of justice, humanity and 
the public good. 

We beg also to suggest, that for examining and determin- 
ing what persons should be transferred from the prisons or 
poorhouses or other hospitals, to the separate hospital de- 
partment above recommended, or therefrom to prison or the 
other hospitals, the law should provide that, either the 
Board of Public Charities by their general agent, or some 
other commissioner or commissioners specially appointed, — 
who should make themselves thoroughly acquainted with 
the condition and wants of the insane throughout the Com- 
monwealth (i. e. of such as are kept under detention and re- 
straint), who could be supposed to have no interests to sub- 
serve but those of justice, humanity and the public good, and 
who would act systematically and on general and impartial 
principles, — should 

HAVE THE ULTIMATE CONTROL, 

with such advice from the superintendents of the State hospi- 
tals and other experts as they may require ; or as in the case 
of the New York law in this behalf, with the aid and advice 
of a commissioner of lunacy, specially appointed to aid the 
Board of Public Charities in their action. 

If your honorable bodies should prefer the appointment 
of an independent commission, this Board will, of course, 
be entirely satisfied. 



In all this, we presume, of course, that the courts would, 
in the first instance, make such disposition of the insane, 
who come under their judicial cognizance, as they should by 
law he authorized or required to do. Provision might 
also be made for carrying out any decision of the aforesaid 
commission or of the General Agent of this Board, which 
may be alleged to be erroneous or unjust, to some court to 
be reviewed and either confirmed or reversed. It is remark- 
able that in the late convention of Superintendents of the 
insane, to which reference has before been made, one of its 
members, having alluded to the provision of the New York 
law, empowering a judge to dispose, according to his discre- 
tion, of persons acquitted of murder and other crimes on the 
ground of insanity — sending them either to a convict hospi- 
tal or some other, exclaimed, " Too great a sweep of power 
for one man !" And almost immediately after another mem- 
ber naively declared that "persons acquitted of a criminal 
act on the ground of insanity should be placed in the hospi- 
tal for the insane, and the moment the superintendent con- 
siders him a fit subject for the asylum for convicts, he should 
be sent there ! " 

The truth is the very fact of the malady being obscure, 
and thus causing the general public to neglect its victims, 
excepting through mere curiosity, makes it important that 
the State, representing the community, should have a special 
agency whose duty it shall be to scrutinize the condition 
and needs of this class. Such a commission can understand 
these, as well as the physicians or attendants, and have no 
considerations of personal convenience to warp the judg- 
ment. The simple point of diagnosis of the particular 
phase of the malady is all in which, he would necessarily be 
deficient. 

It is the universal practice of governments which appoint 
such commissions, to constitute them of laymen. 

We have said that the wrongs of the insane in prisons and 
poorhouses continue as they were, when Miss Dix's " Memo- 
rial " caused the State to provide a hospital for their alleviation. 



100 



We now say that, although every hospital built and pro- 
jected, has been recommended to the Legislature with the 
same view, and, seemingly, with the same design, the system 
pursued has never extinguished and never will extinguish 
or even abate the evil. There are twelve hundred of these (out- 
side of Philadelphia, where alone there are one thousand and 
fifty in the almshouse asylum,) suffering incarceration and 
neglect. The unnecessary costliness of these hospital estab- 
lishments, for the indigent insane, and the liberal admission 
into them of " paying patients," forbid the realization of the 
intentions and the desires of the Legislature and the public. 



In conclusion, 

we think we may assume the following as established princi- 
ples or settled points 

1. The State is bound to provide, not only for the safe- 
keeping, but for the proper care and treatment of all her 
insane poor. 

2. Neither jails, penitentiaries nor poorhouses are proper 
places for their detention or treatment, whatever may be the 
character of their insanity, or whether it be recent or of long 
standing — curable or incurable. 

3. A person, while insane can be guilty of no crime, and it 
is both unjust and inhuman to consign innocent men and 
women to the ignominious cells of jails and penitentiaries, or 
to the foul kennels of poorhouses, simply because, though 
insane and irresponsible, they are "dangerous to be at large." 

4. Even insane convicts ought not to be retained in the 
cells of prisons, but transferred to some hospital where they 
may be both safely kept and receive appropriate medical treat- 
ment. 

In view of the foregoing admitted facts and principles, this 
Board begs to renew and repeat, 

BY WAY OF SUMMARY, THE FOLLOWING RECOMMENDATIONS, 

and most earnestly to urge them upon the attention of the 
Legislature. 



101 



1. That the State should make prompt and adequate pro- 
vision in General State Hospitals for all the insane poor in 
the Commonwealth, determine by law how their expenses 
should be paid, require the several counties either to make 
equally suitable provision in proper hospitals for their 
insane poor, or to send them to the State Hospitals, and 
require the authorities of these hospitals to receive and 
retain them, as long as they need hospital care. 

2. That a separate wing or department of one of the State 
Hospitals, — to be under the charge of its superintendent, — 
should be suitably constructed, arranged and equipped for 
the reception, custody and proper medical -treatment (1) of 
those persons who continue insane after completing the 
period of their sentence for crime; (2) of those who, being 
charged Avith the commission of crime while sane, are ad- 
judged insane before trial or sentence, (3) of those who are 
acquitted of certain crimes, as murder, arson, rape, burglary, 
&c, on the ground of insanity, and are adjudged too danger- 
ous to be discharged, and, (4) perhaps, of other dangerous 
lunatics; — all these to be sent either to this department, or 
to the ordinary hospitals, according to the discretion of the 
court or of the proper commission. 

3. That all other insane persons, who are brought up for 
the sentence of the courts, should be sent to the ordinary 
hospitals, 

SO THAT NO INSANE PERSONS IN ANY CASE SHOULD BE 
COMMITTED TO PRISON. 

4. That, until an entirely separate hospital may he provided 
for their accommodation, " insane convicts " should be admitted 
to appropriate quarters in the above mentioned special department, 
— their insanity to be ascertained and their transfer regu- 
lated according to provisions of law, and they themselves 
allowed as much or as little association with the other in 
mates of this department as the Superintendent of the hos- 
pital shall judge proper and expedient. 

5. That a special Commission, appointed for the purpose, 



102 



or the Board of Public Charities of the Commonwealth, be 
authorized to transfer from the other State hospitals to the 
special department above proposed, and from that to the 
ordinary hospitals, such persons as upon due examination 
and inquiry, shall be judged proper. Whether this same 
Commission should have authority to remove insane persons 
from prison to the special hospital department, we leave with- 
out any expression of opinion. Definite provisions as to this 
might be prescribed by statute. 

6. Inasmuch as there are strong and well founded objec- 
tions to condemning any person as incurably insane before- 
hand, and as the presence of incurables is no more disadvan- 
tageous to the curable, and often less so, than some others 
who are curable, the Board are not prepared to recommend 
their systematic separation, but, under the presumption that 

GENERAL HOSPITALS 

will be provided for all the insane poor, — leave them to be 
retained in the several hospitals and distributed in each as 
the Superintendents may deem most advisable. 

Such are our recommendations, and we present and urge 
them, not as theories, but as practical suggestions, looking 
to positive and immediate action. 

We beg to call the particular attention of the members of 
the General Assembly to the fact that most of these recom- 
mendations are supported and guaranteed, not by the mere 

OPINION, BUT BY THE DIRECT TESTIMONY OF THIS BOARD 

AND ITS general agent ; and not only so, but by both the 
opinions and the testimony of the present and former judges 

OF OUR CRIMINAL COURTS, the JUDGES OF THE SUPREME 

court, and by the inspectors and wardens of our 
penitentiaries, as well as by those of many Superinten- 
dents of the insane whose declarations, on this behalf, are 
embodied in this report: as also by those of learned 
physicians and intelligent philanthropists, who have 



103 



made the facts of this case a subject of special examination 
and study ; — to which many other names might have been 
added from all parts of the State, if pains had been taken to 
secure them : — and, finally, by the example axd experience 

OF OTHER STATES. 

Eespectfully submitted, 

GEO. L. HARBISON, 

President. 
G. DAWSON COLEMAN, 
HIESTER CLYMER, 
WILLIAM BAKE WELL, 
GEORGE BULLOCK, 
A. C. NOYES, 
FRANCIS WELLS, 
DILLER LUTHER, M.D. 

General Agent. 
Harrisburg, December 31s*, 1873. 



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